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dc.creatorMalizos, K.en
dc.creatorRoidis, N. T.en
dc.creatorPoultsides, L.en
dc.creatorBasdekis, G.en
dc.creatorMoraitis, T.en
dc.creatorXenakis, T.en
dc.date.accessioned2015-11-23T10:38:31Z
dc.date.available2015-11-23T10:38:31Z
dc.date.issued2009
dc.identifier.issn1477447
dc.identifier.urihttp://hdl.handle.net/11615/30553
dc.description.abstractA 24-year-old patient with a history of juvenile rheumatoid arthritis underwent a primary cementless left total hip arthroplasty (THA). The original THA consisted of an Optifix 54 cup with a 3-mm thick polyethylene liner, an Optifix size 4 stem (Smith & Nephew Richards, Memphis, Tennessee) and a Biolox aluminum 32-mm femoral head. Fourteen years later, radiographs demonstrated extensive wear of the polyethylene liner resulting in direct articulation and abrasion wear of the ceramic femoral head on the cup and a bubble sign. This article presents a case of a catastrophic failure of a ceramic/polyethylene bearing with destruction of the polyethylene liner and the metallic shell and protrusio of the nonfractured ceramic head through the metallic shell. To our knowledge this is the first description of extensive metallosis and subsequent radiograph bubble sign not presenting as a result of wear of a metal-on-metal articulation. At the time of revision surgery-Hydrocel TNT Monoblock 58 cup (Zimmer, Warsaw, Indiana), Wagner 265/14 stem (Zimmer), and a Co/Cr 28-mm head-copious metallic debris was seen both macroscopically and histologically, with the ceramic head protruding behind the metallic shell. Multiple factors may have been responsible for this failure including a thin polyethylene shell, a suboptimal locking mechanism, gamma in air sterilization for polyethylene, multiple screw-holes that reduce the contact surface between shell and polyethylene, the rough surface on the inside of the shell and non-articular wear at the metal polyethylene interface within the acetabular component and the high demands of this active young patient. Copyright ® 2009 SLACK Incorporated. All rights reserved.en
dc.sourceOrthopedicsen
dc.source.urihttp://www.scopus.com/inward/record.url?eid=2-s2.0-68149132589&partnerID=40&md5=80dc12429b61e5bd4bf57e94e2a4e261
dc.subjectpolyethyleneen
dc.subjectmetalen
dc.subjectadulten
dc.subjectarticleen
dc.subjectcase reporten
dc.subjectceramic prosthesisen
dc.subjectdevice removalen
dc.subjectfemur headen
dc.subjecthumanen
dc.subjecthuman tissueen
dc.subjectjuvenile rheumatoid arthritisen
dc.subjectmaleen
dc.subjectmetallosisen
dc.subjectosteotomyen
dc.subjectprosthesis failureen
dc.subjectprosthesis looseningen
dc.subjecttotal hip prosthesisen
dc.subjectceramicsen
dc.subjecthipen
dc.subjecthip arthroplastyen
dc.subjectradiographyen
dc.subjectreoperationen
dc.subjectArthroplasty, Replacement, Hipen
dc.subjectHip Jointen
dc.subjectHumansen
dc.subjectMetalsen
dc.subjectYoung Adulten
dc.titleProtrusio of a ceramic femoral head through the acetabular metallic shell, extensive metallosis and 'bubble sign'en
dc.typejournalArticleen


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