Willmann G
CeramTec AG Geschäftsbereich Medizintechnik Postfach 1149, D-73 201 Plochingen.
Biomed Tech (Berl). 2001 Dec;46(12):343-50.
Retrieved ceramic femoral heads and acetabular cups were investigated. On the basis of the case studies, the reasons for revision are discussed. Wear patterns and wear rates were found to differ from those observed in hip simulating testing. Monolithic ceramic cups showed a high wear rate. Owing to their limited range of motion, ceramic "mushroom heads" are associated with impingement that leads to a high risk of cup loosening, high wear rates and in vivo fractures. The combination of ceramic "mushroom heads" and cups is not recommended. An evaluation of complications shows that some can be explained by patient behaviour--e.g. Japanese sitting position, horse riding. Designers need to develop new concepts offering a larger range of motion, for example, with head diameters of 32 and 36 mm that reduce the risk of impingement, subluxation and dislocation, while increasing the range of motion. The potential of ceramic/ceramic coupling has been known since the 70s, and ceramic concepts for total hip replacement are currently experiencing a renaissance, although further developments are still possible.
对取出的陶瓷股骨头和髋臼杯进行了研究。基于这些案例研究，讨论了翻修的原因。发现磨损模式和磨损率与髋关节模拟测试中观察到的不同。整体陶瓷杯显示出较高的磨损率。由于其活动范围有限，陶瓷“蘑菇头”会导致撞击，进而导致髋臼杯松动、磨损率高和体内骨折的高风险。不建议使用陶瓷“蘑菇头”与髋臼杯的组合。对并发症的评估表明，有些可以用患者行为来解释，例如日式坐姿、骑马。设计者需要开发新的概念，提供更大的活动范围，例如，采用直径为32毫米和36毫米的股骨头，以降低撞击、半脱位和脱位的风险，同时增加活动范围。陶瓷/陶瓷组合的潜力自70年代就已为人所知，目前全髋关节置换的陶瓷概念正在复兴，尽管仍有可能进一步发展。
