Short-term outcome of ceramic-on-ceramic total hip replacement in young adult patients
Background: Ceramic-on-ceramic (CoC) total hip replacement (THR) was developed to minimize debris and osteolytic reaction. The major concern is its brittleness. The aim of this study was to evaluate the short-term outcome of CoC THR in young adult patients.
Methods: 11 patients, 13 THR procedures, were followed up until six months after surgery in Cipto Mangunkusumo Hospital. Evaluation included Harris hip score (HHS), visual analog scale (VAS), patients’ complaint, short form-36 (SF-36), and acetabular and femoral component angles. Data were analyzed using Wilcoxon signed rank test, paired t-test, and Spearman test.
Results: The average age of the patients was 33.6 years old and 55% of them were female. Systemic lupus erythematosus was the main causative disease for THR. The VAS average decreased before surgery and after six months of surgery (5 to 1). Pre- and post-operative HHS and SF-36 increased significantly by (25 to 92) and (21 to 54) respectively. Squeaking sound was reported by two patients. No correlation was found between acetabular and femoral component and squeaking incidence.
Conclusion: CoC THR showed excellent short term outcome for young adult patients. With proper indications, CoC THR ensures excellent clinical outcomes and promising survivorship.
Synder M, Drobniewski M, Sibiński M. Long-term results of cementless hip arthroplasty with ceramic-on-ceramic articulation. Int Orthop. 2012;36(11):2225-9. http://dx.doi.org/10.1007/s00264-012-1639-x
Sugano N, Takao M, Sakai T, Nishii T, Miki H, Ohzono K. Eleven-to 14-year follow-up results of cementless total hip arthroplasty using a third-generation alumina ceramic-on-ceramic bearing. J Arthroplasty. 2011;27(5):736-41. http://dx.doi.org/10.1016/j.arth.2011.08.017
Hannouche D, Zaoui A, Zadegan F, Sedel L, Nizard R. Thirty years of experience with alumina-on-alumina bearing in total hip arthroplasty. Int Orthop. 2011 Feb; 35(2):207-13. http://dx.doi.org/10.1007/s00264-010-1187-1
Yeung E, Bott PT, Chana R, Jackson MP, Holloway I, Walter WL, et al. Mid-term results of third-generation alumina-on-alumina ceramic bearings in cementless total hip arthroplasty: a ten-year minimum follow up. J Bone Joint Surg Am. 2012;94(2):138-44. http://dx.doi.org/10.2106/JBJS.J.00331
McDonnell SM, Boyce G, Baré J, Young D, Shimmin AJ. The incidence of noise generation arising from the large-diameter Delta Motion ceramic total hip bearing. Bone Joint J. 2013;95-B(2):160-5. http://dx.doi.org/10.1302/0301-620X.95B2.30450
So K, Kanatani TK, Kuroda Y, Nakamura T, Matsuda S, Akiyama H. Good short-term outcome of primary total hip arthroplasty with cementless bioactive glass ceramic bottom-coated implants: 109 hips followed for 3-9 years. Acta Orthop. 2012;83(6):599-603. http://dx.doi.org/10.3109/17453674.2012.736173
Solarino G, Piazzolla A, Notarnicola A, Moretti L, Tafuri L, De Giorgi S, et al. Long-term results of 32-mm alumina-on-alumina THA for avascular necrosis of the femoral head. J Orthop Traumatol. 2012;13(1):21-7. http://dx.doi.org/10.1007/s10195-011-0174-7
D'Antonio JA, Capello WN, Naughton M. Ceramic bearings for total hip arthroplasty have high survivorship at 10 years. Clin Orthop Relat Res. 2012;470(2):373-81. http://dx.doi.org/10.1007/s11999-011-2076-7
Taylor S, Manley MT, Sutton K. The role of stripe wear in causing acoustic emissions from alumina ceramic-on-ceramic bearings. J Arthroplasty. 2007;22(7Suppl3):47-51. http://dx.doi.org/10.1016/j.arth.2007.05.038
Chevillotte C, Pibarot V, Carret JP, Bejui-Hugues J, Guyen O. Hip squeaking: a 10-year follow-up study. J Arthroplasty. 2012;27(6):1008-13. http://dx.doi.org/10.1016/j.arth.2011.11.024
Ortiguera CJ, Pulliam IT, Cabanela ME. Total hip arthroplasty for osteonecrosis: matched-pair analysis of 188 hips with long-term follow-up. J Arthroplasty. 1999;14(1):21-8. http://dx.doi.org/10.1016/S0883-5403(99)90197-3
Berry DJ, Harmsen WS, Cabanela ME, Morrey BF. Twenty-five-year survivorship of two thousand consecutive primary charnley total hip replacements: factors affecting survivorship of acetabular and femoral components. J Bone Joint Surg Am. 2002;84-A(2):171-7
Millar NL, Halai M, McKenna R, McGraw IW, Millar LL, Hadidi M. Uncemented ceramic-on-ceramic THA in adults with osteonecrosis of the femoral head. Orthopedics. 2010;33(11):795. http://dx.doi.org/10.3928/01477447-20100924-13
Affatato S, Traina F, Toni A. Microseparation and stripe wear in alumina-on-alumina hip implants. Int J Artif Organs. 2011;34(6):506-12. http://dx.doi.org/10.5301/IJAO.2011.8457
Walter WL, Insley GM, Walter WK, Tuke MA. Edge loading in third generation alumina ceramic-on-ceramic bearings: stripe wear. J Arthroplasty. 2004;19(4):402-13. http://dx.doi.org/10.1016/j.arth.2003.09.018
Restrepo C, Matar WY, Parvizi J, Rothman RH, Hozack WJ. Natural history of squeaking after total hip arthroplasty. Clin Orthop Relat Res. 2010;468(9):2340-5. http://dx.doi.org/10.1007/s11999-009-1223-x
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