Clinical Case Sharing-Hip Joint Replacement

Clinical Case Sharing-Hip Joint Replacement

● Basic Information: Ms. Chen, female, 92 years old.
● Brief Description of the Condition: Five years ago, she accidentally fell and experienced pain in the left hip. She rested at home and the pain subsided. One month ago, the patient’s left hip pain intensified. In early February this year, the patient visited the Tongliang District Hospital of Chongqing and was admitted to the Joint Department 1 of the Orthopedics Department due to “old-type fracture of the left femoral neck; left femoral head necrosis; hypertension; coronary heart disease”.
● Auxiliary Examinations: CT examination, X-ray examination
● Preoperative Diagnosis: Old-type fracture of the left femoral neck; left femoral head necrosis
● Treatment Plan: Total hip replacement of the left side
● Surgery Completion: Under the doctor’s guidance, The hip joint prosthesis from Beijing Zhongantaihua (ZATH) was successfully implanted. The operation was completed smoothly and the patient’s vital signs are stable.

What types of hip prostheses are there? 

1、Metal ball head and polyethylene (plastic) lining
Standard metal balls and polyethylene cup liners have been in use since the early 1960s. Scientific research shows that the use of improved polyethylene liners, known as “highly cross-linked” polyethylene liners, can significantly reduce the overall wear rate of implants. Due to its durability and other related properties, metallic polyethylene has been the material of choice for orthopedic surgeons for artificial hip joint since the first hip replacement surgeries were performed. The metal ball is made of cobalt-chromium alloy and the lining is made of polyethylene.

2、Ceramic ball head and polyethylene (plastic) lining
Ceramic tips are harder than metal and are the most scratch-resistant implant material. Ceramics currently used in joint replacement surgeries have hard, scratch-resistant, ultra-smooth surfaces that can significantly reduce the wear rate of polyethylene friction interfaces. The potential wear rate of this implant is lower than the potential wear rate of metal on polyethylene.

3、Metal ball head and metal liner
Metal-on-metal friction interfaces (cobalt-chromium alloys, sometimes stainless steel) have been used as early as 1955, but were not approved by the FDA for use in the United States until 1999. As technology advances, wear is significantly reduced, resulting in less inflammation and bone loss. Metal bearings are available in a variety of sizes (ranging from 28mm to 60mm), as well as a variety of neck length options. However, long-term postoperative reports indicate that metal, as a relatively active ion, accumulates metal debris due to long-term wear and tear, which can lead to bone dissolution around the joint prosthesis, ultimately leading to loosening and deformation of the joint prosthesis. The operation failed.

4、Ceramic ball head and ceramic lining
In these artificial hip joint systems, traditional metal balls and polyethylene liners have been replaced by high-strength ceramics, which are known for their ultra-low-wear properties. However, while having the advantages of high quality and low wear, they also inevitably have the disadvantage of high cost.


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