RSS-Feed abonnieren
DOI: 10.1055/s-0043-124767
Keramik-Keramik-Gleitpaarung in der Revisionsendoprothetik des Hüftgelenks
Artikel in mehreren Sprachen: English | deutschPublikationsverlauf
Publikationsdatum:
27. Februar 2018 (online)
![](https://www.thieme-connect.de/media/zfo/201803/lookinside/thumbnails/10-1055-s-0043-124767_ou5224_de-1.jpg)
Zusammenfassung
Hintergrund Die Anwendung von modernen Keramik-Keramik-Gleitpaarungen (Ceramic-on-Ceramic, CoC) in der primären Hüftendoprothetik ist zunehmend und gut dokumentiert. Sie hat ihren Stellenwert insbesondere bei jungen und aktiven Patienten und zeigt Vorteile hinsichtlich Biokompatibilität, Abriebrate und Lubrikationseigenschaft. Dagegen ist die Gleitpaarung in der Revisionsendoprothetik seltener genutzt und unzureichend untersucht. Ziel dieser Übersichtsarbeit ist eine Analyse der vorliegenden Literatur zu CoC-Gleitpaarungen in der Revisionsendoprothetik des Hüftgelenks.
Material und Methoden Es erfolgte eine systematische Literaturrecherche der MEDLINE-Datenbank, wobei ausschließlich Artikel in englischer Sprache eingeschlossen wurden. Die initiale Suche ergab 555 Artikel, die nach Analyse definierter Ein- und Ausschlusskriterien auf 26 reduziert wurden und zur Metaanalyse dieser Arbeit eingeschlossen werden konnten.
Ergebnisse In den analysierten Studien wurden insgesamt 1846 Operationen eingeschlossen, wobei keine Level-I-Studie identifiziert werden konnte. In 18 Studien wurde auf Revisionen mit Verwendung von CoC-Gleitpaarungen bei 111 Patienten aufgrund unterschiedlicher Indikationen eingegangen. Bei insgesamt 6 dieser Studien wurden Outcome-Parameter mittels Harris Hip Score (HHS) oder eines anderen Scoring-Systems erhoben, sodass hier eine quantitative Datenanalyse durchgeführt werden konnte. Die Zeitspanne des Follow-ups lag bei 2,1 – 19 Jahren mit einer mittleren Nachuntersuchungsdauer von 9,3 Jahren. Es zeigte sich ein gutes funktionelles Ergebnis, mit einem kumulativen Mittelwert für den HHS von 87 Punkten. Die Luxationsrate lag bei 3,45% und das Risiko eines Keramikbruchs des Aluminiumoxidkopfes bei 0,35% (1 Studie). Squeaking wurde als Komplikation der CoC-Gleitpaarung bei Revisionen in 3 Studien berichtet, mit einer kalkulierten Inzidenz von 0,52%.
Schlussfolgerung Moderne CoC-Gleitpaarungen zeigen in präklinischen und retrospektiven Studien im Revisionsfall Vorteile und sind eine vielversprechende Alternative zu herkömmlichen Verfahren. Dies gilt insbesondere für jüngere Patienten und Wechselsituationen mit erhöhtem Luxationsrisiko, Zementallergien, Protheseninfektion und stattgehabten Keramikbrüchen. Es fehlen randomisierte kontrollierte Studien, die Gleitpaarungen hinsichtlich Luxationsraten, Materialversagen oder klinischem Outcome vergleichen, um eine optimale Lösung im Revisionsfall empfehlen zu können.
-
References/Literatur
- 1 National Joint Registry for England, Wales, Northern Ireland and the Isle of Man Editorial Board. 12th Annual Report 2015. Im Internet: http://www.njrcentre.org.uk/njrcentre/Portals/0/Documents/England/Reports/12th annual report/NJR Online Annual Report 2015.pdf; Stand: 19.06.2017
- 2 Graves S. AOANJRR Committee. Australian Orthopaedic Association National Joint Registry: Annual Report 2015. Im Internet: https://aoanjrr.sahmri.com/de/annual-reports-2015 Stand: 19.06.2017
- 3 Ong KL, Lau E, Suggs J. et al. Risk of subsequent revision after primary and revision total joint arthroplasty. Clin Orthop Relat Res 2010; 468: 3070-3076
- 4 Khatod M, Cafri G, Inacio MCS. et al. Revision total hip arthroplasty: factors associated with re-revision surgery. J Bone Joint Surg Am 2015; 97: 359-366
- 5 Graves S. AOANJRR Committee. Australian Orthopaedic Association National Joint Registry: Annual Report 2016. Im Internet: https://aoanjrr.sahmri.com/de/annual-reports-2016 Stand: 19.06.2017
- 6 Kurtz SM, Lau EC, Baykal D. et al. Outcomes of ceramic bearings after revision total hip arthroplasty in the medicare population. J Arthroplasty 2016; 31: 1979-1985
- 7 Boutin P. [Total arthroplasty of the hip by fritted aluminum prosthesis. Experimental study and 1st clinical applications]. Rev Chir Orthop Reparatrice Appar Mot 1972; 58: 229-246
- 8 Mittelmeier H. [New development of wear-resistant ceramic and metal composite prostheses with ribbed support shafts for cement-free implantation]. Hefte Unfallheilkd 1975; 126: 333-336
- 9 Buttaro MA, Zanotti G, Comba FM. et al. Primary total hip arthroplasty with fourth-generation ceramic-on-ceramic: analysis of complications in 939 consecutive cases followed for 2–10 years. J Arthroplasty 2016; 32: 480-486
- 10 Sedel L. Evolution of alumina-on-alumina implants: a review. Clin Orthop Relat Res 2000; 379: 48-54
- 11 Lee YK, Yoon BH, Choi YS. et al. Metal on metal or ceramic on ceramic for cementless total hip arthroplasty: a meta-analysis. J Arthroplasty 2016; 31: 2637-2645
- 12 Smith AJ, Dieppe P, Vernon K. et al. Failure rates of stemmed metal-on-metal hip replacements: analysis of data from the National Joint Registry of England and Wales. Lancet 2012; 379: 1199-1204
- 13 Cole JC, Lemons JE, Eberhardt AW. Gamma irradiation alters fatigue-crack behavior and fracture toughness in 1900H and GUR 1050 UHMWPE. J Biomed Mater Res 2002; 63: 559-566
- 14 Baker DA, Hastings RS, Pruitt L. Study of fatigue resistance of chemical and radiation crosslinked medical grade ultrahigh molecular weight polyethylene. J Biomed Mater Res 1999; 46: 573-581
- 15 Kim YH, Park JW, Kim JS. Isolated revision of an acetabular component to a ceramic-on-ceramic bearing in patients under 50 years of age. Bone Joint J 2015; 97-B: 1197-1203
- 16 Pitto RP, Sedel L. Periprosthetic joint infection in hip arthroplasty: is there an association between infection and bearing surface type?. Clin Orthop Relat Res 2016; 474: 2213-2218
- 17 Gallo J, Stewart T, Novotny R. et al. Early fracture of a plasma cup ceramic liner: a case report and surface analysis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2007; 151: 341-346
- 18 Tso CY, Chiu KH, Cheung KW. Ceramic insert dislodgment after revision ceramic-on-ceramic total hip arthroplasty. J Arthroplasty 2010; 25: 660.e5-7
- 19 Sariali E, Stewart T, Mamoudy P. et al. Undetected fracture of an alumina ceramic on ceramic hip prosthesis. J Arthroplasty 2010; 25: 658.e1-5
- 20 Lee SC, Jung KA, Nam CH. et al. Acetabular screw head-induced ceramic acetabular liner fracture in cementless ceramic-on-ceramic total hip arthroplasty. Orthopedics 2010; DOI: 10.3928/01477447-20100329-30.
- 21 Lee LH, Langton D, Green S. Adverse sequelae following revision of a total hip replacement for a fractured ceramic component: case report. SICOT-J 2015; 1: 28
- 22 Shafafy R, Foote J, Hargrove R. A novel technique for identification of fractured ceramic acetabular liner in total hip arthroplasty: a case report. Hip Int 2016; 25: 492-494
- 23 Hannouche D, Nich C, Bizot P. et al. Fractures of ceramic bearings: history and present status. Clin Orthop Relat Res 2003; 417: 19-26
- 24 Allain J, Roudot-Thoraval F, Delecrin J. et al. Revision total hip arthroplasty performed after fracture of a ceramic femoral head. A multicenter survivorship study. J Bone Joint Surg Am 2003; 85-A: 825-830
- 25 Traina F, Tassinari E, De Fine M. et al. Revision of ceramic hip replacements for fracture of a ceramic component: AAOS exhibit selection. J Bone Joint Surg Am 2011; 93: e147
- 26 Koo KH, Ha YC, Kim SY. et al. Revision of ceramic head fracture after third generation ceramic-on-ceramic total hip arthroplasty. J Arthroplasty 2014; 29: 214-218
- 27 Trebše R, Mihelič A, Levašič V. et al. Results of revision of total hip arthroplasty for alumina ceramic-on-ceramic bearing fracture. Hip Int 2016; 26: 237-243
- 28 Schmidt-Braekling T, Renner L, Mintz DN. et al. Do changes in the production process affect the outcome of ceramic liners: a 3-year follow-up study. J Arthroplasty 2016; 32: 1314-1317
- 29 Matharu GS, Daniel J, Ziaee H. et al. Failure of a novel ceramic-on-ceramic hip resurfacing prosthesis. J Arthroplasty 2015; 30: 416-418
- 30 Hannouche D, Delambre J, Zadegan F. et al. Is there a risk in placing a ceramic head on a previously implanted trunion?. Clin Orthop Relat Res 2010; 468: 3322-3327
- 31 Chana R, Facek M, Tilley S. et al. Ceramic-on-ceramic bearings in young patients: outcomes and activity levels at minimum ten-year follow-up. Bone Joint J 2013; 95-B: 1603-1609
- 32 Seo BH, Ryu DJ, Kang JS. et al. Primary total hip arthroplasty using 3rd generation ceramic-on-ceramic articulation. Hip Int 2016; 26: 468-473
- 33 Chang JD, Kamdar R, Yoo JH. et al. Third-generation ceramic-on-ceramic bearing surfaces in revision total hip arthroplasty. J Arthroplasty 2009; 24: 1231-1235
- 34 Jack CM, Molloy DO, Walter WL. et al. The use of ceramic-on-ceramic bearings in isolated revision of the acetabular component. Bone Joint J 2013; 95-B: 333-338
- 35 Yoo JJ, Yoon PW, Lee YK. et al. Revision total hip arthroplasty using an alumina-on-alumina bearing surface in patients with osteolysis. J Arthroplasty 2013; 28: 132-138
- 36 Kim Y, Kim YH, Hwang KT. et al. Isolated acetabular revision with ceramic-on-ceramic bearings using a ceramic head with a metal sleeve. J Arthroplasty 2014; 29: 2420-2423
- 37 Yang JH, Yang SJ, Kang JS. et al. Cementless revision total hip arthroplasty with ceramic articulation. Hip Pelvis 2015; 27: 223-231
- 38 Wong JML, Liu YL, Graves S. et al. What is the rerevision rate after revising a hip resurfacing arthroplasty? Analysis from the AOANJRR. Clin Orthop Relat Res 2015; 473: 3458-3464
- 39 Singh JA, Schleck C, Harmsen S. et al. Clinically important improvement thresholds for Harris Hip Score and its ability to predict revision risk after primary total hip arthroplasty. BMC Musculoskelet Disord 2016; 17: 256
- 40 Hu D, Tie K, Yang X. et al. Comparison of ceramic-on-ceramic to metal-on-polyethylene bearing surfaces in total hip arthroplasty: a meta-analysis of randomized controlled trials. J Orthop Surg Res 2015; 10: 22
- 41 Hernigou P, Homma Y, Pidet O. et al. Ceramic-on-ceramic bearing decreases the cumulative long-term risk of dislocation. Clin Orthop Relat Res 2013; 471: 3875-3882
- 42 Guo L, Yang Y, An B. et al. Risk factors for dislocation after revision total hip arthroplasty: A systematic review and meta-analysis. Int J Surg 2016; 38: 123-129
- 43 Hernigou P, Roussignol X, Delambre J. et al. Ceramic-on-ceramic THA associated with fewer dislocations and less muscle degeneration by preserving muscle progenitors. Clin Orthop Relat Res 2015; 473: 3762-3769
- 44 Rimondini L, Cerroni L, Carrassi A. et al. Bacterial colonization of zirconia ceramic surfaces: an in vitro and in vivo study. Int J Oral Maxillofac Implants 2002; 17: 793-798
- 45 Piconi C, Ionescu AC, Cochis A. et al. Bioceramic materials show reduced pathological biofilm formation. Key Eng Mater 2014; 631: 448-453
- 46 Kunutsor SK, Whitehouse MR, Blom AW. et al. Re-infection outcomes following one- and two-stage surgical revision of infected hip prosthesis: a systematic review and meta-analysis. PLoS One 2015; 10: e0139166
- 47 Wirtz DC. Ceramic-on-Ceramic in Revision Total Hip Arthroplasty. Kongressvortrag. Wien: Ceramtec Symposium, EFORT; 2017
- 48 Ganzer D, Forke L, Irlenbusch U. Two-year follow-up of revision total hip arthroplasty using a ceramic revision head with a retained well-fixed femoral component: a case series. J Med Case Rep 2014; 8: 434
- 49 de Thomasson E, Conso C, Mazel C. A well-fixed femoral stem facing a failed acetabular component: to exchange or not? A 5- to 15-year follow-up study. Orthop Traumatol Surg Res 2012; 98: 24-29
- 50 Stathopoulos IP, Lampropoulou-Adamidou KI, Vlamis JA. et al. One-component revision in total hip arthroplasty: the fate of the retained component. J Arthroplasty 2014; 29: 2007-2012
- 51 Helwig P, Konstantinidis L, Hirschmüller A. et al. Modular sleeves with ceramic heads in isolated acetabular cup revision in younger patients-laboratory and experimental analysis of suitability and clinical outcomes. Int Orthop 2013; 37: 15-19
- 52 Preuss R, Haeussler KL, Flohr M. et al. Fretting corrosion and trunnion wear – is it also a problem for sleeved ceramic heads?. Semin Arthroplasty 2012; 23: 251-257
- 53 Owen DH, Russell NC, Smith PN. et al. An estimation of the incidence of squeaking and revision surgery for squeaking in ceramic-on-ceramic total hip replacement: a meta-analysis and report from the Australian Orthopaedic Association National Joint Registry. Bone Joint J 2014; 96-B: 181-187
- 54 Levy YD, Munir S, Donohoo S. et al. Review on squeaking hips. World J Orthop 2015; 6: 812-820
- 55 Abdel MP, Heyse TJ, Elpers ME. et al. Ceramic liner fractures presenting as squeaking after primary total hip arthroplasty. J Bone Joint Surg Am 2014; 96: 27-31
- 56 Sentürk U, Perka C. [Ceramic-on-ceramic bearings in total hip arthroplasty (THA)]. Z Orthop Unfall 2015; 153: 198-202
- 57 Rambani R, Kepecs DM, Mäkinen TJ. et al. Revision total hip arthroplasty for fractured ceramic bearings: a review of best practices for revision cases. J Arthroplasty 2017; 32: 1959-1964
- 58 Gozzini PA, Schmid C, Dalla Pria P. Massive wear in a CoCrMo head following the fracture of an alumina head. Hip Int 2008; 12: 37-42