Alumina-Debris-Induced Osteolysis in Contemporary Alumina-on-Alumina Total Hip Arthroplasty

Abstract

Aceramic-on-ceramic bearing coupling, because of its
\nqualities of reduced friction and wear, is an attractive
\nalternative bearing surface in total hip arthroplasty.
\nThe use of such bearing couplings is likely to reduce problems
\nrelated to polyethylene wear debris1-6. Osteolysis has only
\nrarely been reported in association with ceramic-on-ceramic
\nbearing couplings, and reports are generally limited to cases
\ninvolving early generation ceramic bearings or loosened prostheses7,8.
\nRecently, several cases of osteolysis have been reported
\nafter total hip arthroplasty with use of a contemporary
\nalumina bearing, but these reports only described the femoral
\nscalloping seen on radiographs and did not present any histological
\nevidence that ceramic particles were the causative
\nfactor9. We present the case of a patient who had formation of
\na large amount of osteolysis about both the acetabulum and
\nthe proximal part of the femur, induced by ceramic wear
\nparticles from a well-functioning contemporary alumina-onalumina
\ntotal hip prosthesis. The patient was informed that
\ndata concerning the case would be submitted for publication,
\nand she consented.