image: This is a picture of fragments of a fractured ceramic femoral head. view more
Credit: JBJS Case Connector
Needham, MA. - JBJS Case Connector, an online case report journal published by The Journal of Bone & Joint Surgery, has issued a 'Watch' regarding the rare but potentially catastrophic fracture of ceramic femoral heads used in hip replacements.
Ceramic hip components are often chosen for younger patients to minimize long-term wear. Ceramic femoral head fractures arise mainly from trauma; non-compatible, damaged, or contaminated femoral head/stem taper connections; or material or manufacturing defects.
This Watch was prompted by a case report by Pomeroy et al. in the Dec. 23, 2015 JBJS Case Connector, a report by Heiner and Mahoney in the Oct. 22, 2014 JBJS Case Connector, and a 2014 article in BMJ Case Reports by Tucker and Acharya. Those three reports described patients who experienced ceramic femoral-head fractures anywhere from 10 days to 14 years after hip-replacement surgery.
Because ceramic head fractures are more likely to occur from insults during or after implantation than from manufacturing defects, the Watch includes four "golden rules" surgeons can follow to reduce the risk of these events, including making sure that the tapers on both the head and stem are compatible in all dimensions. The Watch also emphasizes the importance of patient education, during which patients should be encouraged to promptly report any and all postsurgical irregularities.
"The publication of 'Watches' helps fulfill our mission to serve the orthopaedic community," commented Marc Swiontkowski, MD, co-editor of JBJS Case Connector. "The 'Watch' designation may encourage the orthopaedic community to either demonstrate that these are isolated, unrelated cases or sharpen the focus further by rigorously evaluating the intervention and/or reporting related cases."
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About JBJS Case Connector
JBJS Case Connector is an online, cross-referenced journal containing thousands of orthopaedic case reports. It compiles symptoms, conditions, and demographic details to empower surgeons to find cases similar to theirs and to mine the database to reveal emerging trends and identify patterns, distinguishing between truly rare cases and repeated, related single instances of a larger problem. For more information, visit caseconnector.jbjs.org.
About JBJS
JBJS, Inc., is a not-for-profit publisher specializing in orthopaedic information. It publishes The Journal of Bone & Joint Surgery, which has been the most valued source of information for orthopaedic surgeons and researchers for more than 125 years. The Journal is the gold standard in peer-reviewed scientific information in the field -- essential reading for orthopaedic surgeons worldwide. Other JBJS publications include JBJS Case Connector, JBJS Essential Surgical Techniques, and JBJS Reviews, along with CME and professional development products. Twitter: @jbjs.