Mid-term results of ceramic on ceramic total hip replacement in young adults

Abstract

Background: With the increased use of (THA) in younger patients with more activity and more wear and ‎stress, the ceramic on ceramic bearing surfaces decrease the rates of wear and increase the prosthesis ‎longevity. ‎ Patients and Methods: 58 patients (66 hips) evaluated after THA operation using ceramic bearing surfaces. ‎There were 40 males and 18 females with mean age of 34 years (range: 26-48). The etiology was avascular ‎necrosis of femoral head in 42 hips, and posttraumatic hip arthrosis in 24 hips. Clinically, the ‎indications of operation were disabling pain, marked restriction in hip motions, and flexion adduction ‎deformity. Harris hip score was used in clinical ‎evaluation preoperatively, postoperatively and at last follow ‎‎up for all patients. For radiological evaluation we used the criteria of Lins et al for acetabular evaluation ‎and Engh et al. for femoral evaluation. ‎ Results: The mean follow-up period was 82 (range, 66–102) months. Clinically, the mean Harris Hip Score ‎improved from 50.5 (range, 24–66) to 89 (range, 45–98) [p < 0.001]. At the last follow ¬up, excellent results ‎were in 24 hips (36.5%), and good results in 30 (45.5%), fair in 8 hips (12%), and 4 hips (6%) had poor results. ‎No hip had evidence of subsidence, loosening, or osteolysis. A radiolucency of 1 mm of was seen in 2 ‎zones in 8 hips (14%), (in 5 hips it was in zones 1 & 2, and in zones 2 & 3 in 3 hips). There were no ‎progression of these lucencies up to last follow up. In the femoral stem, there were four stems with ‎radiolucent line of 3mm in 2 zones but clinically the patients had no pain and stems were stable until last ‎visit. ‎ Conclusion: ‎ Total hip replacement with ceramic on ceramic bearing surfaces are functioning well with minimal complications and low rate of loosening in a 5-8 years follow up according to this study.