Department of Orthopedics, The First Affiliated Hospital of Zhejiang Traditional Chinese Medicine University, Hangzhou, China.
Department of Orthopedics, 71069The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
J Orthop Surg (Hong Kong). 2022 May-Aug;30(2):10225536221109960. doi: 10.1177/10225536221109960.
Ceramic-on-ceramic couplings are attractive alternative bearing surfaces that have been reported to eliminate or reduce problems related to polyethylene wear debris. However, the material in THA still remains one of the major concerns about the risk of fracture, due to its brittleness.
The present study aims at reporting the fracture rate of a series of ceramic-on-ceramic THAs with use of the sandwich liner combined with a ceramic femoral head, and attempt to detect the relative risk factors, possible cause and assesse the medium-term clinical results.
We retrospectively evaluated 282 patients (300 hips) with use of the sandwich liner ceramic-on-ceramic THA between 2001 and 2009 at three-centers. Patient assessment was based on demographic factors, including age, weight, gender and body-mass index. All patients were evaluated clinically and radio-graphically or computed tomography in consideration of dislocation, osteolysis, periprosthetic fracture, infection, loosening and implant fracture.
five ceramic sandwich liners fracture (1.7%) were observed at an average of 7.3 years follow-up. These factors were irrelevant to the ceramic liner fracture, including age ( = 0.205), weight ( = 0.241), gender ( = 0.553), body-mass index ( = 0.736), inclination ( = 0.727), and anteversion ( = 0.606). The overall survival was 91.4% at 12 years with revision as the endpoint. Other complications included dislocation in two, perprosthetic fracture in two and osteolysis in eight hips. No hip had aseptic loosening of the implants was seen.
We found that the sandwich liner may be lead to a high rate of alumina fracture and osteolysis. We have discontinued the use of sandwich liner with THA since 2009.
陶瓷-陶瓷结合是一种有吸引力的替代轴承表面，据报道，它可以消除或减少与聚乙烯磨损碎片相关的问题。然而，由于其脆性，髋关节置换术中的材料仍然是骨折风险的主要关注点之一。
本研究旨在报告使用三明治衬垫联合陶瓷股骨头的一系列陶瓷-陶瓷全髋关节置换术的骨折率，并试图检测相关的风险因素、可能的原因，并评估中期临床结果。
我们回顾性评估了 2001 年至 2009 年在三个中心使用三明治衬垫陶瓷-陶瓷全髋关节置换术的 282 例患者（300 髋）。患者评估基于人口统计学因素，包括年龄、体重、性别和体重指数。所有患者均进行了临床和影像学评估，或考虑到脱位、骨溶解、假体周围骨折、感染、松动和植入物骨折进行了计算机断层扫描。
在平均 7.3 年的随访中，观察到 5 例（1.7%）陶瓷三明治衬垫骨折。这些因素与陶瓷衬垫骨折无关，包括年龄（=0.205）、体重（=0.241）、性别（=0.553）、体重指数（=0.736）、倾斜度（=0.727）和前倾角（=0.606）。以翻修为终点，12 年的总体生存率为 91.4%。其他并发症包括 2 例脱位、2 例假体周围骨折和 8 例骨溶解。未发现植入物无菌性松动。
我们发现三明治衬垫可能导致氧化铝骨折和骨溶解的发生率较高。自 2009 年以来，我们已停止在全髋关节置换术中使用三明治衬垫。
