The ceramic-on-ceramic strategy in acetabular revision faces potential limitations due to the femoral stem, as the implantation of ceramic ball head on a previously used taper is not recommended. Delta (r) ball heads with titanium sleeves have been proposed to avoid femoral revision. The study reports a minimum 3 years follow-up experience using this strategy. This series report 42 revisions (16 metal-on-metal and 26 PE THA) in 39 patients (mean age 59.2 years, mean BMI 25). The 12-14, 5°46 sleeves were used in 24 cases and 10-12, 6° in 18 cases. (32mm ball head in 26 cases and 36 mm in 16 cases). Titanium serum level has been studied to detect the potential release from the sleeve-taper interface.Introduction
Materials and Methods
Wear performances and fracture toughness of the alumina-matrix composite (AMC) Biolox-delta(r) are pointed out in the literature. This study is a prospective monocentric evaluation of 32 and 36 mm AMC/AMC bearing surfaces. 141 THA were included prospectively since 2006 in 127 patients. (62 females, 65 males, mean age 62, 2 years, mean BMI 25, 5). 134 cases were primary implantations. Mean follow-up is 40.9 months (29.8-53.4). In all patients we used the same cementless stem and cup. Clinical and radiological data were evaluated with a special attention for ceramic fracture and squeaking.Introduction
Material and methods
There is ambiguity concerning the nomenclature and classification of fractures of the ring of the second cervical vertebra (C2). Disruption of the pars interarticularis which defines true traumatic spondylolisthesis of C2, is often wrongly called a pedicle fracture. Our aim in this study was to assess the influence of asymmetry on the anatomical and functional outcome and to evaluate the criteria of instability established by Roy-Camille et al. We studied the plain radiographs and CT scans of 24 patients: 13 were judged to be asymmetrical, ten were considered unstable and 14 stable. Treatment was with a Minerva jacket in 15 fractures and by operation in nine. Surgery was undertaken in patients with severe C2 to C3 sprains. One patient with an unstable lesion refused operation and was treated conservatively with a poor radiological result. Our study showed that asymmetry of the fracture did not affect the outcomes of treatment and should not therefore influence decisions in treatment. The criteria of Roy-Camille seem to be reliable and useful. We prefer the posterior approach to the cervical spine, which allows both stabilisation of the fracture and correction of a local kyphosis.
