Analysis of retrieved alumina ceramic components from Mittelmeier total hip prostheses

This study analyses explanted prostheses from a single surgeon's 16-yr series of Mittelmeier cementless total hip replacements. The patient group was young (patients aged 15-60, average 40) and active. Revision was related to various factors. All components were measured using a Kemco 3D coordinate measurement machine. Wear surfaces and linear wear penetrations of 11 retrieved Mittelmeier Autophor ceramic hip components (average implantation time 8.6 yr, range 1-13 yr) were analysed and the different types of wear identified. Surface analysis was then performed using Talysurf contacting profilometry and scanning electron microscopy. Three types of wear were identified: low wear (1 case), stripe wear (6 cases) and severe wear (4 cases). Stripe wear was characterised as a stripe of worn area on the head up to 150 microns deep whilst the rest of the head showed very low wear. The cups in the stripe wear cases were worn over about 40-50% of the surface. Severe wear cases had very large areas of heavy wear and visible volume loss on both heads and cups. The four cases of severe wear were associated with abnormal clinical histories.