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首页> 外文期刊>Archives of Orthopaedic and Trauma Surgery >Extremely high fracture rate of a modular acetabular component with a sandwich polyethylene ceramic insertion for THA: a preliminary report
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Extremely high fracture rate of a modular acetabular component with a sandwich polyethylene ceramic insertion for THA: a preliminary report

机译：初步报告，带有夹层聚乙烯陶瓷插入物的模块化髋臼组件的极高断裂率：初步报告

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摘要

Improvements of ceramic components and design changes have reduced failure rates over the past 30 years in total hip arthroplasty. We present a series of n = 11 cases with ceramic failure out of n = 113 implantations, from which n = 66 were ceramic-on-ceramic (n = 50 with ceramic insert with sandwich in polyethylene and n = 16 with directly fixed ceramic inlay) and n = 47 ceramic on polyethylene bearings, between 1999 and 2001 after introduction of a new implantation system to the market. The overall fracture rate of ceramic for the whole series (n = 113) was 9.7%. For the combination ceramic head with UHMW-PE (n = 47) the fracture rate was 2.1%. For the combination ceramic with ceramic (n = 66) the fracture rate was 15.2%. For the combination ceramic with ceramic sandwich in PE (n = 50) the failure rate was 18%. Only three patients experienced a trauma. Demography of patients (age, gender, body weight and BMI) was not statistically different between patients with failed ceramics and the rest of the patients making patient-specific risk factors unlikely to be an explanation for the failures. Retrospective X-ray analysis of the cup positioning did not show significant difference between failed and non-failed implants in terms of mean cup inclination and version making also operation-specific factors unlikely to be the only reason of this high failure rate. Therefore, manufacturer-specific factors such as design features may have contributed to this high failure rate. Further analysis of the whole series with biomechanical testing of the retrieved material needs to be performed.
机译：在过去的30年中，陶瓷部件的改进和设计变更降低了全髋关节置换术的失败率。我们在n = 113的植入物中，出现了n = 11的一系列陶瓷失败病例，其中n = 66是陶瓷陶瓷（n = 50，陶瓷插入物，聚乙烯夹层，n = 16，直接固定的陶瓷镶嵌物） ），并在1999年至2001年之间向市场推出了新的植入系统后，在聚乙烯轴承上的n = 47陶瓷。整个系列（n = 113）的陶瓷总断裂率为9.7％。对于UHMW-PE组合陶瓷头（n = 47），断裂率为2.1％。对于陶瓷与陶瓷的组合（n = 66），断裂率为15.2％。对于PE中的陶瓷与陶瓷夹层的组合（n = 50），失败率为18％。只有三名患者遭受了创伤。在陶瓷失败的患者与其余患者之间，患者的人口统计学（年龄，性别，体重和BMI）在统计学上没有差异，使得患者特定的危险因素不太可能解释失败。对杯定位的回顾性X射线分析未显示出失败和未失败植入物之间的平均杯倾斜度和版本之间的显着差异，因此特定于手术的因素也不大可能是这种高失败率的唯一原因。因此，制造商特定的因素（例如设计特征）可能是造成这种高故障率的原因。需要对整个系列进行进一步分析，并对回收的材料进行生物力学测试。

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