alexa Causes of failure of ceramic-on-ceramic and metal-on-metal hip arthroplasties.
Orthopaedics

Orthopaedics

Journal of Arthritis

Author(s): Porat M, Parvizi J, Sharkey PF, Berend KR, Lombardi AV Jr,

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Abstract BACKGROUND: Few large series of hard bearing surfaces have reported on reasons for early failure. A number of unique mechanisms of failure, including fracture, squeaking, and adverse tissue reactions, have been reported with these hard bearing surfaces. However, the incidence varies among the published studies. QUESTIONS/PURPOSES: To confirm the incidences, we identified the etiologies of early failures of hard-on-hard bearing surfaces for ceramic-on-ceramic and metal-on-metal THAs. METHODS: We retrospectively reviewed records of 2907 THAs with hard-on-hard bearing surfaces implanted between 1996 and 2009; 1697 (58\%) had ceramic-on-ceramic and 1210 (42\%) had metal-on-metal bearing surfaces. We recorded bearing-related complications and compared them to nonspecific reasons for revision THA. The minimum followup of the ceramic-on-ceramic and metal-on-metal cohorts was 6 months (mean, 48 months; range, 6-97 months) and 24 months (mean, 60 months; range, 24-178 months), respectively. RESULTS: The overall revision rate for ceramic-on-ceramic THA was 2.2\% (38 of 1697), with aseptic loosening accounting for 55\% of revisions (femur or acetabulum). The bearing accounted for 13\% of the revisions in the ceramic-on-ceramic THA cohort. The overall metal-on-metal revision rate was 5.4\% (65 of 1210), 17 involving adverse tissue reactions related to the metal-on-metal bearing surface (17 of 1210, 1.4\% of cases; 17 of 65, 26\% of revisions). CONCLUSIONS: Twenty-six percent of the revisions from metal-on-metal and 13\% of ceramic-on ceramic were bearing related. The overall short- to medium-term revision rate was 2.2\% and 5.4\% for ceramic-on-ceramic and metal-on-metal, respectively. The most common etiology of failure was loosening of the femoral or acetabular components. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of level of evidence.
This article was published in Clin Orthop Relat Res and referenced in Journal of Arthritis

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