Overall , there was a notable enhancement of joint function after the procedure , with a satisfactory mid- and long-term survival of the ceramic components , which is comparable to that of the conventional alloy components reported previously .
However , revision due to aseptic loosening , wear , and component fracture appeared to be rare , demonstrating the safety of in vivo use of ceramic bearings in the TKA procedure .
Conclusions Ceramic TKA implants show similar post-operative clinical results and survival rate compared to their conventional metallic counterparts .
Our results confirmed the safety of in vivo use of ceramic bearings in TKA , with rare implant breakage and aseptic loosening .
Purpose Ceramic bearings have been widely used in total hip arthroplasty ( THA ) , which result ed in satisfactory clinical outcomes due to the excellent tribological characteristics of the implants .
However , ceramic components are not commonly used in total knee arthroplasty ( TKA ) because of brittleness .
This study aim ed to gather and analyze information regarding the clinical outcomes ( including survival without revision , causes of revision , functional outcome , and incidence of loosening ) and reach a definitive conclusion about the use of ceramic femoral components in total knee arthroplasty .
Prostaglandin E2 level in tissue surrounding aseptic failed total hips
Summary Production of inflammatory mediators ( IM ) by cells and specifically macrophages around loosened implants may be responsible for their loosening . Our hypothesis was that different material s give rise to different amounts of these IM . It is thought that alumina/alumina for total hip replacement ( THR ) , which has been used for 15 years in our orthopedic department , may produce less IM than other systems . We initiated a clinical prospect i ve study to measure the level of prostagl and in E2 ( PGE2 ) in tissue surrounding loosened prostheses to quantify PGE2 production regarding the types of material involved in the friction couple , i.e. , alumina/alumina versus metal/polyethylene , and the type of fixation , i.e. , cemented versus cementless . A total of 29 THR revisions were performed in 28 patients . Four implant groups were identified : alumina/alumina cemented , alumina/alumina cementless , metal/polyethylene cemented , and metal/polyethylene cementless . For each revision , tissues surrounding the failed implants were harvested and processed , and the PGE2 was measured in a blind manner using an immunoassay technique . As the measuring technique was difficult , at least three determinations for each sample were necessary . Some sample s were excluded from the analysis for various reasons , for example , second or further revisions involving many different material s in the past , conjunction of metallic and alumina debris and sample s taken from nonloosened components . Finally , 15 sample s were considered adequate for inclusion in this study . Two groups were analyzed and compared : the alumina/alumina couple and the metal/polyethylene couple . Tissue surrounding the first group demonstrated a PGE2 level of 69 ± 56 fmol/mg wet weight compared to 202 ± 156 fmol/mg for the second . The Wilcoxon test was applied , and there was a statistical difference ( P < 0.05 ) . When the alumina/alumina cemented group was compared to the alumina/alumina cementless group , there was a tendency to less PGE2 with the cemented , but the difference was not statistically significant . Results thus demonstrate that alumina/alumina produces less IM than metal/polyethylene . However , these results do not indicate whether this is related to the type of debris , the amount , or both . This remains a preliminary study . Further studies with more sample s , other mediators and growth factors , and a precise comparison to histological findings are still necessary
Overall , there was a notable enhancement of joint function after the procedure , with a satisfactory mid- and long-term survival of the ceramic components , which is comparable to that of the conventional alloy components reported previously .
However , revision due to aseptic loosening , wear , and component fracture appeared to be rare , demonstrating the safety of in vivo use of ceramic bearings in the TKA procedure .
Conclusions Ceramic TKA implants show similar post-operative clinical results and survival rate compared to their conventional metallic counterparts .
Our results confirmed the safety of in vivo use of ceramic bearings in TKA , with rare implant breakage and aseptic loosening .
Purpose Ceramic bearings have been widely used in total hip arthroplasty ( THA ) , which result ed in satisfactory clinical outcomes due to the excellent tribological characteristics of the implants .
However , ceramic components are not commonly used in total knee arthroplasty ( TKA ) because of brittleness .
This study aim ed to gather and analyze information regarding the clinical outcomes ( including survival without revision , causes of revision , functional outcome , and incidence of loosening ) and reach a definitive conclusion about the use of ceramic femoral components in total knee arthroplasty .