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By W. Bonfield, G. W. Hastings and K.E. Tanner (Eds.)

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Extra resources for Bioceramics. Proceedings of the 4th International Symposium on Ceramics in Medicine London, UK, September 1991

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ABSTRACT A new prosthesis for the total joint replacement of the first metatarso-phalangeal joint was developed. The prosthesis has a phalangeal and a metatarsal component , both are alumina made. The design is anatomic and was chosen after a study of 20 human cadaveric first metatarso phalangeal joints. The bone prosthesis fixation is uncemented. Three sizes are available. The results of the first five implantations are positive. INTRODUCTION First metatarso-phalangeal joint degenerative diseases can be treated by several surgical techniques.

Poor rate of wear debris, non or minimal wear of the alumina acetabular component, good bone quality giving a better fixation of the acetabular component, minimal femoral failure rate can explain these differences. Our study, in under fifty years old patients, showed that 87 prostheses (21) had a 94% survival rate at eight years. Conclusion Alumina-alumina combination for hip replacement gave overall similar clinical results compared to the polyethylene-metal combination. Breakage of the prosthetic femoral head and of the socket has been virtually eliminated as a complication of this type of arthroplasty.

15 of the 24 revisions were done for aseptic loosening of the socket (14) or bipolar loosening (1), 5 for fracture of the socket (2) or the femoral head (3), 3 for septic loosening, 1 for dislocation due to an inadéquat acetabular positioning. 17 of the 24 revisions were done after a primary arthroplasty. 5 years). 7 observations could be made : (i) one fracture occured with the 22mm 30 Bioceramics Volume 4 diameter femoral head, (ii) for the second one the surgeon noticed a mismatch between the head and the acetabular component, (iii) the other one was unexplained.

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