[Ceramic cups for hip endoprostheses. 3: On the problem of osseointegration of monolithic cups]

The combination of ceramic with ceramic offers the option of minimising wear and the need for revision in total hip replacement. At first, uncemented monolithic ceramic sockets were implanted. Some of these did not prove successful. The prerequisites for fixation of an implant by bony integration are discussed i.e. the structural and surface compatibility of an implant. The reasons for the high revision rate associated with monolithic ceramic sockets are discussed. Using monolithic ceramic sockets only contact osteogenesis can in principle be achieved, which does not suffice for good long-term fixation. In many cases, soft tissue can be found at the ceramic socket/bone interface, and the ceramic sockets may as a result migrate and penetrate, creating conditions that elevate the rate of wear to unacceptable levels.