Abstract
BackgroundThe ideal bearing surface for patients of avascular necrosis (AVN) undergoing total hip arthroplasty (THA) remains controversial. The purpose of this study is to evaluate the clinical outcomes, health-related quality of life (HRQL), and wear of the bearing surface between ceramic-on-ceramic (CoC) and ceramic-on-highly cross-linked polyethylene (CoXPE) THA for patients of AVN after midterm follow-up.MethodsWe performed a retrospective case-control analysis of 93 CoC and 77 CoXPE consecutive THAs for patients of AVN. The cases were followed at a minimum 5 years follow-up (average 7 years). Harris hip score (HHS) score and bearing-related complications were assessed. The health-related quality of life (HRQL) was assessed with the Short Form 36 (SF-36). Plain radiographs and computed tomography (CT) were used for radiographic evaluation.ResultsBoth the CoC group and CoXPE group showed statistically significant improvements in HHS scores with no difference between the two bearing surfaces. There was no significant difference as for SF-36 at the latest follow-up between two groups, except for significant higher scores in the dimensions of general health in the CoC group (75.7 vs 64.7, P = 0.032). No radiographic evidence of osteolysis and loosening was present at the final follow-up. The mean wear rate of the CoC was 0.0096 mm/year and the CoXPE was 0.047 mm/year after evaluation with reconstructed CT.ConclusionsCoC THAs acts as well as CoXPE THAs for patients with femoral head avascular necrosis after midterm follow-up. CoC bearing can significantly decrease the wearing rate than CoXPE bearing.
Highlights
The ideal bearing surface for patients of avascular necrosis (AVN) undergoing total hip arthroplasty (THA) remains controversial
While the number of overall total joint arthroplasties continues to increase, the greatest rise is projected to be in the young patient population, with 52% of all joint replacements predicted to be in patients younger than 65 years old [1]
We aim to evaluate the clinical outcomes, health-related quality of life (HRQL), complications, and wear rate of the bearing surface between CoC and Ceramic-on-highly cross-linked polyethylene (CoXPE) for THA patients with avascular necrosis of the femoral head (AVNF) with a minimum follow-up of 5 years
Summary
The ideal bearing surface for patients of avascular necrosis (AVN) undergoing total hip arthroplasty (THA) remains controversial. The purpose of this study is to evaluate the clinical outcomes, health-related quality of life (HRQL), and wear of the bearing surface between ceramic-on-ceramic (CoC) and ceramic-on-highly cross-linked polyethylene (CoXPE) THA for patients of AVN after midterm follow-up. A ceramic-on-highly cross-linked polyethylene (CoXPE) articulation may decrease long-term wear [9] and potentially have a longer survivorship with less ceramic fracture and squeaking than CoC-bearing surface and is increased use in the younger population (less than 65 years old) over the last 5 years as demonstrated in the National Joint Registry [10]. Health-related quality of life (HRQL) after THA has been reported only in a handful of studies [12, 13] In this retrospective study, we aim to evaluate the clinical outcomes, HRQL, complications, and wear rate of the bearing surface between CoC and CoXPE for THA patients with AVNF with a minimum follow-up of 5 years
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