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Mittelmeier ceramic-ceramic prosthesis after 10 years

E Garcia-Cimbrelo¹, J M Martinez-Sayanes, A Minuesa

¹Department of Orthopaedics, Hospital La Paz, Universidad Autónoma de Madrid, Spain.

The Journal of Arthroplasty

|October 1, 1996

Summary

The Mittelmeier Mark II ceramic-ceramic total hip prosthesis showed poor long-term outcomes, with high rates of loosening and fibrous fixation. Ceramic wear debris was found, despite no significant acetabular wear.

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Area of Science:

Orthopedic Surgery
Biomaterials Science
Biomedical Engineering

Background:

The Mittelmeier Mark II (Autophor, Osteo AG) is a cementless ceramic-ceramic total hip prosthesis.
Between 1978 and 1984, 83 such prostheses were implanted.

Purpose of the Study:

To evaluate the long-term clinical performance and histological findings of the Mittelmeier Mark II prosthesis.
To compare its outcomes with other cemented and uncemented hip prostheses.

Main Methods:

Clinical analysis of 83 Mittelmeier Mark II cementless total hip prostheses.
Histological examination of retrieved tissues from revised hips.
Radiographic assessment of component loosening and wear over a mean follow-up of 12.3 years.

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Main Results:

16% of prostheses required revision at 16 years, with common acetabular and stem loosening (53% and 15% respectively).
Osseointegration was infrequent; fibrous stable fixation was noted in 64% of stems.
No significant acetabular wear was observed, but intracellular ceramic wear debris was present in retrieved tissues.

Conclusions:

The Mittelmeier Mark II prosthesis demonstrated inferior long-term results compared to other hip implant types.
High rates of loosening and the presence of ceramic debris indicate potential concerns for this implant design.