Total Hip Arthroplasty with Ceramic-on-Ceramic Articulation: Minimum 5-year Follow-up Results

Abstract

Purpose : To evaluate the medium-term clinical and radiographic results of uncemented total hip arthroplasty with ceramic-on-ceramic articulation. Materials and Methods : From February 1999 to August 2000, fifty-two primary total hip arthroplasties were performed on forty-two patients using a ceramic-on-ceramic bearing implant. The mean follow-up period was 5.4 years (range, 5-6.6 years) and the mean age at surgery was 43.2 years (range, 19-66 years). The clinical results were evaluated using the Harris hip score. The radiographic evaluations were carried out in terms of the stability of the components, the prevalence of osteolysis and wear. Results : At the most recent follow-up, the mean preoperative Harris hip score improved from 63 points (range, 26-93 points) to 97 points (range, 82-100 points). The Harris hip score showed excellent results in 49 hips (94%) and good results in 3 hips (6%). Fixation by bone ingrowth was noted in all cases and there was no case with osteolysis or a deep infection. Ceramic wear was not detectable on the plain radiograph. Complications included one case of dislocation, one case of a fracture of the ceramic femoral head and one case of an intraoperative periprosthetic proximal femoral crack. Conclusion : Ceramic-on-ceramic articulation showed excellent clinical and radiographic results in terms of wear, osteolysis and loosening. A further follow-up study should be performed to evaluate the long-term clinical and radiographic results with special focus on the fracture of the ceramic material.