Thursday, April 7, 2011

Now What? If you remove the Depuy implant and replace it, what goes in its place? What are the alternatives and risks associated with them? (4 of 4 in a series)

Your surgeon will select the design of the hip replacement and size of femoral ball to give you the range of motion and stability that you need to function. There are several different choices of hip implants to consider, each using varying materials and having different pros and cons:
  • Metal Ball and Polyethylene Liners
  • Ceramic Ball and Polyethylene Liner
  • Metal Ball and Metal Liner
  • Ceramic Ball and Ceramic Liner
Nice videos of each type can be found on this site:  http://bonesmart.org/hip/total-hip-replacement-implants/
Ceramic Ball and Ceramic Liner
If you are a very active individual or a relatively young patient, your surgeon may prescribe an all-ceramic hip joint. All-ceramic hip joints have been used in Europe since the 1980’s but have only more recently received the FDA’s approval for marketing in the United States.

In these hip joints, the traditional metal ball and polyethylene liner are replaced by a high-strength ceramic bearing that has the reputation for ultra low wear performance. Clinical studies, monitored by the FDA and begun in 1998, have demonstrated excellent performance although it should be noted that ceramic has been used in hip replacements for many years prior to that.

Ceramic is the hardest implant material used in the body, and has the lowest wear rate of all, to almost immeasurable amounts (1000 times less than Metal-on-polyethylene). Consequently, there is usually no inflammation or bone loss, nor systemic distribution of wear products in the body. New ceramics offer improved strength and more versatile sizing options.

Ceramic-on-Ceramic implants have a potential wear rate of about 0.0001 millimeters each year

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