Quarter Century Outcomes of Alumina Ceramic-on-Ceramic Total Hip Arthroplasty.
Journal
The Journal of arthroplasty
ISSN: 1532-8406
Titre abrégé: J Arthroplasty
Pays: United States
ID NLM: 8703515
Informations de publication
Date de publication:
15 Oct 2024
15 Oct 2024
Historique:
received:
25
07
2024
revised:
03
10
2024
accepted:
07
10
2024
medline:
18
10
2024
pubmed:
18
10
2024
entrez:
17
10
2024
Statut:
aheadofprint
Résumé
Alumina ceramic-on-ceramic (CoC) bearings were widely used in total hip arthroplasty (THA) due to their superior wear resistance and inert properties, making them ideal for young, active patients who require long-lasting implants. This study aimed to synthesize findings from previous reports, providing a comprehensive follow-up of at least 25 years on the clinical and radiologic outcomes, the prevalence of osteolysis, and implant survivorship in patients undergoing primary cementless CoC THA. We have previously reported five-to-ten-year outcomes following the implementation of third-generation alumina-on-alumina bearings in a consecutive series of 100 primary cementless THAs. This report updates those results with a minimum follow-up of 25 years. Of the original cohort, 58 patients who had 67 hips were available for the latest follow-up. Clinical assessments were performed using the Harris Hip Score (HHS) and pain questionnaires. Radiographic evaluations were employed to assess implant fixation and osteolysis. At the final follow-up, the implant survival rate was an impressive 96.3%, with revision of the implant as the endpoint. The mean HHS improved significantly from preoperative values to 90.1, indicating excellent functional outcomes. The incidence of ceramic-related noise increased over time, with three cases of ceramic head fractures requiring a change of bearings. Notably, the extent of stem notching observed in earlier reports did not show further progression. Radiologically, all implants demonstrated bony ingrowth with no signs of aseptic loosening or major osteolysis. The long-term (minimum 25-year) follow-up of alumina-on-alumina bearings in primary cementless THA demonstrates outstanding implant survivorship, excellent functional outcomes, and minimal adverse effects over twenty-five years. Despite some issues like ceramic-related noise and component fractures, the overall performance of CoC bearings remains highly encouraging, particularly suitable for young, active patients. Surgeons should provide appropriate education to both potential THA candidates and patients who already have THAs with CoC bearings.
Sections du résumé
BACKGROUND
BACKGROUND
Alumina ceramic-on-ceramic (CoC) bearings were widely used in total hip arthroplasty (THA) due to their superior wear resistance and inert properties, making them ideal for young, active patients who require long-lasting implants. This study aimed to synthesize findings from previous reports, providing a comprehensive follow-up of at least 25 years on the clinical and radiologic outcomes, the prevalence of osteolysis, and implant survivorship in patients undergoing primary cementless CoC THA.
METHODS
METHODS
We have previously reported five-to-ten-year outcomes following the implementation of third-generation alumina-on-alumina bearings in a consecutive series of 100 primary cementless THAs. This report updates those results with a minimum follow-up of 25 years. Of the original cohort, 58 patients who had 67 hips were available for the latest follow-up. Clinical assessments were performed using the Harris Hip Score (HHS) and pain questionnaires. Radiographic evaluations were employed to assess implant fixation and osteolysis.
RESULTS
RESULTS
At the final follow-up, the implant survival rate was an impressive 96.3%, with revision of the implant as the endpoint. The mean HHS improved significantly from preoperative values to 90.1, indicating excellent functional outcomes. The incidence of ceramic-related noise increased over time, with three cases of ceramic head fractures requiring a change of bearings. Notably, the extent of stem notching observed in earlier reports did not show further progression. Radiologically, all implants demonstrated bony ingrowth with no signs of aseptic loosening or major osteolysis.
CONCLUSION
CONCLUSIONS
The long-term (minimum 25-year) follow-up of alumina-on-alumina bearings in primary cementless THA demonstrates outstanding implant survivorship, excellent functional outcomes, and minimal adverse effects over twenty-five years. Despite some issues like ceramic-related noise and component fractures, the overall performance of CoC bearings remains highly encouraging, particularly suitable for young, active patients. Surgeons should provide appropriate education to both potential THA candidates and patients who already have THAs with CoC bearings.
Identifiants
pubmed: 39419413
pii: S0883-5403(24)01022-2
doi: 10.1016/j.arth.2024.10.009
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Elsevier Inc. All rights reserved.