Primary Total Hip Arthroplasty With Ceramic-On-Ceramic Articulations: Analysis of a Single-Center Series of 1,083 Hips at a Minimum of 10-Year Follow-Up |
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| Institution: | 1. Medical School of Chinese PLA, Beijing, China;2. Department of Orthopedics, The First Medical Center of Chinese PLA General Hospital, Beijing, China;3. Senior Department of Orthopedics, Fourth Medical Center of PLA General Hospital, Beijing, China;1. Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania;2. Department of Orthopaedics & Sports Medicine, Maine Medical Partners, South Portland, Maine;3. OrthoCarolina, Charlotte, North Carolina;4. American Association of Hip and Knee Surgeons, Chicago, Illinois;1. Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d''anca e di ginocchio, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy;2. Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy;3. DIBINEM, University of Bologna, Bologna, Italy;1. Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea;2. Division of Biostatistics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea;3. Department of Orthopedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea;1. Department of Orthopaedic Surgery, George Washington University Hospital, Washington, District of Columbia;2. Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland |
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| Abstract: | BackgroundThere are limited long-term results of using ceramic-on-ceramic (CoC) bearings in total hip arthroplasty (THA) in a large number of patient cohorts. The purpose of this study was to evaluate the minimum 10-year clinical and radiological outcomes and survivorship in a single surgeon series of CoC-THA.MethodsAmong the 1,039 patients (1,391 hips) who underwent primary THA at our institution between 2008 and 2011, 49 patients (69 hips) experienced paralysis or death, and 194 patients (239 hips, 19%) were lost to follow-up. The remaining 796 patients (1,083 hips) were assessed at a mean of 11 years (range, 10 to 13 years) using the modified Harris hip score (mHHS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and a questionnaire on articular noises. Survival analysis was used to estimate the survivorship. Radiological evaluation was performed on 869 hips at the final follow-up.ResultsSurvivorship at 11 years was 98.3% for revision or aseptic loosening, and 98.2% for reoperation. At the final follow-up, the mean mHHS and WOMAC scores were 93 (range, 12 to 100) and 14.4 (range, 3 to 66), respectively. There were 131 (12%) hips that experienced squeaking, but no patient required revision. No fracture of the ceramic was observed. Radiological evaluation at the final follow-up revealed that 3 (0.3%) hips exhibited loosening, 2 (0.2%) had femoral osteolysis, 81(9.3%) acquired radiolucencies, and 35 (4%) showed heterotopic ossification.ConclusionThis CoC bearing for THA had a high survivorship and excellent functional outcomes for at least 10 years. |
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| Keywords: | total hip arthroplasty ceramic-on-ceramic bearings survivorship clinical outcome complication squeaking |
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