Considerations on ceramic prosthesis explants.

The authors report data obtained for 11 cases of explants of prostheses having ceramic joint surfaces. The wear phenomena observed in 9 prostheses, including 1 case with breakage of the ceramic head, was moderate: 20-22,000 debris per mu 2. In 2 cases the wear was massive, with a concentration of debris in the peri-implant tissues 5-10 times greater (100,000-218,000 debris per mu 2). An explanation for the trigger mechanism of wear phenomena is proposed: the cases of massive wear are related to loosening of the acetabulum. A histological examination of the bone tissue surrounding a stem covered with alumina (Al2O3) carried out in three cases allowed us to observe an area of demineralization measuring approximately 500 mu of tissue in contact with the ceramic coating. The osteomalacia could be caused by the diffusion of alumina ions.