Ceramic-on-Ceramic Total Hip Arthroplasty: Minimum of Six-Year Follow-up Study

Abstract

BackgroundThis study examines the clinical and radiologic results of ceramic-on-ceramic total hip arthroplasties with regard to wear, osteolysis, and fracture of the ceramic after a minimum follow-up of six years.MethodsWe evaluated the results of a consecutive series of 148 primary ceramic-on-ceramic total hip arthroplasties that had been performed between May 2001 and October 2005 in 142 patients. The mean age was 57.2 years (range, 23 to 81 years). The mean follow-up period was 7.8 years (range, 6.1 to 10.1 years). Preoperative diagnosis was avascular necrosis in 77 hips (52%), degenerative arthritis in 36 hips (24.3%), femur neck fracture in 18 hips (12.2%), rheumatoid arthritis in 15 hips (10.1%), and septic hip sequelae in 2 hips (1.4%). Clinical results were evaluated with the Harris hip score, and the presence of postoperative groin or thigh pain. Radiologic analysis was done with special attention in terms of wear, periprosthetic osteolysis, and ceramic failures.ResultsThe mean Harris hip score improved from 58.3 (range, 10 to 73) to 92.5 (range, 79 to 100) on the latest follow-up evaluation. At final follow-up, groin pain was found in 4 hips (2.7%), and thigh pain was found in 6 hips (4.1%). Radiologically, all femoral stems demonstrated stable fixations without loosening. Radiolucent lines were observed around the stem in 25 hips (16.9%), and around the cup in 4 hips (2.7%). Endosteal new bone formation was observed around the stem in 95 hips (64.2%) and around the cup in 88 hips (59.5%). No osteolysis was observed around the stem and cup. There were 2 hips (1.4%) of inclination changes of acetabular cup, 2 hips (1.4%) of hip dislocation, 1 hip (0.7%) of ceramic head fracture, and 1 hip (0.7%) of squeaking. The Kaplan-Meier survival rate of the prostheses was 98.1% at postoperative 7.8 years.ConclusionsThe ceramic-on-ceramic total hip arthroplasty produced excellent clinical results and implant survival rates with no detectable osteolysis on a minimum six-year follow-up study. The ceramic-on-ceramic couplings could be a reasonable option of primary total hip arthroplasty for variable indications.

Ceramic-on-ceramic bearings total hip arthroplasty in young patients

“…Yoo et al. [35] evaluated 93 primary alumina-on-alumina THAs after a minimum duration of 5 years follow-up. One patient (one hip) had experienced alumina femoral head fracture because of a major motor-vehicle accident.…”

Pelvic X-ray examinations in follow-up of hip arthroplasty or femoral osteosynthesis – Dose reduction and quality criteria

“…Since ceramic unlike polyethylene-metal components will usually show no wearing [20], precise delineation of the prosthesis head is not necessary. A rare problem of ceramic components, however, is material fracture [21], a complication we did not encounter in any study participant.…”

“…Other important factors are the fact that gonads of both sexes are located in the radiation field and the frequent repetition of radiography during routine follow-up. Although no national-or European-binding guidelines on the frequency of X-ray examinations in the follow-up of THA exist [22], four routine follow-up examinations within the first two years and frequent radiography examinations in a two-year rhythm for life are practiced in published clinical trials on durability of total hip replacements [20,21].…”

Isolated revision of the acetabular component using alumina-on-alumina bearings without a metal sleeve: A preliminary study

“…[17][18][19] The 10-year survival rate for alumina-on-alumina hip prostheses was reported to be 99.0%. 20 The efficacy of its application in revision THA, however, is still a concern.…”