Hip replacement is among the most commonly performed orthopedic procedures, and the results are excellent. Over 90% of patients have excellent pain relief and improved ability to perform routine daily activities.
Ceramic is the hardest bearing with the least wear. Unfortunately it is also brittle and may not be ideal for patient who intend to run or do impact sports. Fractures of this bearing have been reported although with the latest design of implants this is rare and occurs in only 0.004% of patients. A revision operation following a ceramic fracture however does not always have a good long term outcome.
Purpose of the Device
This total hip replacement is indicated for patients with painful, disabling hip joint disease caused by a severe form of arthritis.
This total hip replacement should not be used for patients:
- Who may have an infection in or near the hip joint,
- Who are unable to comply with the instructions for preparing for and recovering from the surgery,
- Who do not have enough healthy bone to support fixation of the implants, or
- Whose bones are not fully grown.
Ceramic hip replacements have been developed in an effort to decrease the wearing out of hip implants. Ceramic hip replacment implants are very hard, and very smooth. These characteristics could help to decrease the amount of wear within the implants. In the traditional metal and plastic hip replacements, the plastic wears out slowly over time. As the plastic wears out, small particles of plastic debris are generated. This plastic debris triggers a response by your body which can lead to loosening of the implants over time.
Ceramic hip replacements are an attractive new development in orthopedic surgery. The implants address some of the problems with traditional hip replacements. The newest ceramic hip replacement implants do not wear nearly as much as metal and plastic implants. Because the amount of wear of a hip replacement is related to loosening of the implant over time, wear reduction is among the most researched topics in orthopedics. When a hip replacement loosens, a revision hip replacement may be required. Because revision hip replacements tend to be not as successful as first-time hip replacements, new technology is being developed to prevent loosening. Ceramic hip replacements look to be a reasonable option for patients who may be at risk for wearing out of the hip implant. Patients who are in their 40s and 50s may benefit from these ceramic hip replacements.
Ceramic hip replacement implants have functioned very well in laboratory studies and short-term human investigations. However, they are not perfect, and no one knows how well they work 10, 20, or 30 years after they have been implanted.
One of the most concerning complications of ceramic hip replacements is that they have demonstrated a small rate of so-called 'catastrophic failure.' Because the ceramic hip replacement material is hard and brittle, it can crack, much like a ceramic dish dropped on a tile floor. This used to be more of a problem, and newer ceramic hip replacement implants have been much better. However, the issue of catastrophic failure is still a concern to many physicians.
A ceramic hip replacement can be considered somewhat of an 'educated gamble.' We know that ceramic hip replacements function as though they may be superior to metal and plastic implants, but we do not know that. For most patients, a ceramic hip replacement may not be worth that risk.
The metal and plastic implants work perfectly for the vast majority of patients. Ceramic hip replacements probably only warrant consideration is young patients who may develop complications from wearing out of the implant.
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