J Korean Orthop Assoc.  2008 Aug;43(4):501-505. 10.4055/jkoa.2008.43.4.501.

Metallosis after Revision of a Fractured Ceramic Head onto a Metal-on-Polyethylene Articulation: A Case Report

• Lee KJ
• Jung SW
• Cho CH
• Min BW

• KMID: 1480412
• DOI: http://doi.org/10.4055/jkoa.2008.43.4.501

Abstract

A ceramic articulation thought to be superior to metal-on-polyethylene due to its extremely low coefficient of friction and its potential for resistance to wear. But ceramic is brittle, which makes it theoretically susceptible to fracture. Although many authors have reported that metal-on-polyethylene articular pairing had good results after a ceramic head fracture, there have been few reports about complication due to the remaining ceramic particles after revision surgery. We report here on a case of severe metallosis that was thought to be due to third body wear by the remaining fractured ceramic particles after revision total hip arthroplasty.

Keyword

Total hip arthroplasty; Ceramic head fracture; Third body wear; Metallosis

MeSH Terms

Ceramics
Friction
Head
Hip
Ceramics

Figure

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  Fig. 1 Radiographs of both femurs taken 4 weeks after each surgery show a well-fixed cup and stem.

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  Fig. 2 A radiograph shows the fracture of the ceramic femoral head.

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  Fig. 3 (A) A radiograph immediately before the left hip re-revision surgery shows the bubble sign around the left hip that indicates severe metallosis. (B) A photograph during the re-revision THA reveals fragmented ceramic particles in the black tissue, indicating metallosis.

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  Fig. 4 (A) Many scratches were observed on the abraded surface of the metal head on SEM. (B) Many large particles were embedded in the worn surface of the polyethylene as documented by SEM. (C) Those particles contained aluminum and oxygen on EDS examination.

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  Fig. 5 A photograph shows an example of a metal adapter that, like an extension piece, is fitted onto the deformed cone.

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