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CERAMIC-CERAMIC AND METAL-POLYETHYLENE TOTAL HIP REPLACEMENTS

COMPARISON OF PSEUDOMEMBRANES AFTER LOOSENING

S. Lerouge, BIng, MASc, Doctoral Candidate1; O. Huk, MD, Assistant Professor of Surgery2; L’H. Yahia, PhD, Professor and Director of the Group for Research in Biomechanics and Biomaterials1; J. Witvoet, MD, Orthopaedic Surgeon in Chief3; and L. Sedel, MD, Senior Orthopaedic Surgeon3

1 Institute of Biomedical Engineering, École Polytechnique, CP Box 6079, Succ. Centre Ville, Montreal, Canada H3C 3A7.
2 McGill University, Jewish General Hospital, 3755 Chemin de la Côte Sainte-Catherine, Montreal, Canada H3T 1E2.
3 Hôpital Lariboisière, 2 rue Ambroise Paré, 75475 Paris Cedex 10, France.

Correspondence should be sent to Dr L’H. Yahia.

We made a semiquantitative study of the comparative histology of pseudomembranes from 12 loose cemented ceramic-ceramic and 18 metal-polyethylene total hip replacements. We found no significant difference in cellular reaction between the two groups, but there was a major difference in the origin of the particulate debris. In the metal-polyethylene group, polyethylene of articular origin was predominant, while in the ceramic-ceramic group the cellular reaction appeared to be a response to zirconia ceramic particles used to opacify cement used for fixation.

Isolation and characterisation of the debris showed that the zirconia particles formed the greatest proportion (76%) in ceramic-ceramic hips, while alumina debris of articular origin formed only 12%.

Our study has indicated that aseptic loosening of ceramic cups is not due to a response to debris generated at the articular interface, but to mechanical factors which lead to fragmentation of the cement.




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 J Bone Joint Surg BrHome page
R. Nizard, L. Sedel, D. Hannouche, M. Hamadouche, and P. Bizot
Alumina pairing in total hip replacement
J Bone Joint Surg Br, June 1, 2005; 87-B(6): 755 - 758.
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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General