Incidence of Ceramic Fracture in Contemporary Ceramic-on-Ceramic Total Hip Arthroplasty: A Meta-analysis of Proportions |
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| Institution: | 1. Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, South Korea;2. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea;3. Department of Orthopaedic Surgery, Eulji University College of Medicine, Seoul, South Korea;4. Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, South Korea;5. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea;1. Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d''anca e di ginocchio, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy;2. Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy;1. IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy;2. EndoLab® Mechanical Engineering GmbH Seb.-Tiefenthaler Str. 13 D-83101 Thansau, Rosenheim, Germany;3. CeramTec GmbH, Medical Products Division, CeramTec-Platz, 1-9, 73207 Plochingen, Germany;4. University of Trieste, Department of Engineering and Architecture, Via Alfonso Valerio, 10, 34127 Trieste, Italy;1. Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom;2. Northumbria Healthcare NHS Foundation Trust, Wansbeck General Hospital, Ashington, United Kingdom;3. Centre for Heath Economics at Warwick, Warwick Medical School, University of Warwick, Coventry, United Kingdom;4. The James Cook University Hospital, Middlesbrough, United Kingdom;5. Newcastle University, Newcastle upon Tyne, United Kingdom;1. Centre de Chirurgie Orthopédique du Beaujolais, Ramsay Santé, Arnas, France;2. Artro Institute, Lyon, France;3. Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Service de Chirurgie Orthopédique et Traumatologique, Pierre-Bénite Cedex, France;4. IFSTTAR, Laboratoire de Biomécanique et Mécanique des Chocs, Bron, France;5. ReSurg SA, Nyon, Switzerland;6. Department of Orthopaedic Surgery, Clinique d''Argonay, Ramsay Santé, Annecy, France;1. Department of Basic Medical Sciences, Neuroscience and Organs of Sense, School of Medicine, AOU Policlinico Consorziale, Università di Bari “Aldo Moro”, Bari, Italy;2. Hip Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy |
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| Abstract: | BackgroundWe performed a proportion meta-analysis of currently available data to determine the prevalence of ceramic fracture for each generation.MethodsA total of 10,571 total hip arthroplasties from 45 studies were included. Proportion meta-analysis with a random-effects model was performed to estimate the prevalence of ceramic fracture. To determine whether the ceramic fractures have a fatigue nature and a risk or latent period for the development, postoperative time lapse, patient age, and body mass index were related with ceramic fracture by metaregression analysis.ResultsAs of postoperative 2.0 to 18.8 years, the rate of ceramic fracture was 0.5% (95% CI, 0.3%-0.8%) in the forte group and 0.2% (95% CI, 0.1%-0.4%) in the delta group (P = .059). The ceramic fracture rate for each component was 0.2% (95% CI, 0.1%-0.3%) for the forte head, 0.1% (95% CI, 0.0%-0.2%) for the delta head (P = .210), 0.2% (95% CI, 0.1%-0.3%) for the forte liner, and 0.2% (95% CI, 0.1%-0.4%) for the delta liner (P = .305). The rate of ceramic fracture per 1000 patient-years was 0.9 (95% CI, 0.5-0.13) in the forte group and 0.5 (95% CI, 0.2-0.8) in the delta group (P = .072). In metaregression analysis, no significant associations were found between prevalence of ceramic fracture and postoperative time lapse, patient age, or body mass index.ConclusionsThe rate of ceramic fracture was 0.9/1000 patient-year in the forte group and 0.5/1000 patient-year in the delta group. The results of this study provide baseline data for further studies validating ceramic bearings.Level of EvidenceLevel I, meta-analysis. |
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| Keywords: | ceramic fracture revision total hip arthroplasty meta-analysis |
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