Total hip replacements with ceramic-on-ceramic bearings
Abstract
Introduction: Th e fi rst generation of ceramic- on-ceramic bearings was introduced in France in 1970s. Th e quality of material as well as the design of ceramic components were improved in the second generation developed in 1980s. Th e contemporary, third generation of ceramic-on-ceramic bearings has been in use since mid 1990s. Characteristics: In vivo wear of ceramic-onceramic bearings is very low, <1 mm3/year. Ceramic wear particles formed under conditions of normal wear are nanometer-sized. Despit a common belief, these particles are not completely biologically inert. Th e incidence of ceramic component fracture is low. Clinical results: Long-term data for the fi rst generation of ceramic-on-ceramic bearings show more than 60% survival at 20 years. Currently, mid-term results of the third generation are available. Although the incidence of osteolysis is signifi cantly lower than for metal-on-polyethylene bearings, it is not possible to avoid it completely. Conclusions: Total hip replacements with ceramic-on-ceramic bearings show very low wear, the incidence of osteolysis is low and there are no biocompatibility issues, as is the case with metal-on-metal bearings. Th e possibility of ceramic component fracture is small, however, when it happens it is always a serious complication.Downloads
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