Cementless Total Hip Arthroplasty Using a Ceramic on Ceramic Bearing Surfaces in Patients 60 or More Years Old

Woo-Suk Lee; Sung-Jin Cho; Taek-Soo Jeon; Sang-Bum Kim; Youn-Moo Heo; Jin-Woong Yi; Won-Ki Park

doi:10.5371/jkhs.2010.22.2.122

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Lee, Cho, Jeon, Kim, Heo, Yi, and Park: Cementless Total Hip Arthroplasty Using a Ceramic on Ceramic Bearing Surfaces in Patients 60 or More Years Old

Original Article

The Journal of the Korean Hip Society

The Journal of the Korean Hip Society 2010; 22(2): 122-128.

Published online: 30 June 2010

DOI: https://doi.org/10.5371/jkhs.2010.22.2.122

Cementless Total Hip Arthroplasty Using a Ceramic on Ceramic Bearing Surfaces in Patients 60 or More Years Old

Woo-Suk Lee, MD, Sung-Jin Cho, MD^*, Taek-Soo Jeon, MD^†, Sang-Bum Kim, MD^*, Youn-Moo Heo, MD^*, Jin-Woong Yi, MD^*, Won-Ki Park, MD^*

Department of Orthopedic Surgery, College of Medicine, Yonsei University, Seoul, Korea.

^*Department of Orthopedic Surgery, College of Medicine, Konyang University, Daejeon, Korea.

^†Department of Orthopedic Surgery, College of Medicine, Inje University, Haeundae Hospital, Busan, Korea.

Address reprint request to Woo-Suk Lee, MD. Department of Orthopedic Surgery, College of Medicine, Yonsei University, Gangnam Severance Hospital, 712 Eunjuro, Gangnam-gu, Seoul 135-720, Korea. TEL: +82-2-2019-3417, FAX: +82-2-573-5393, wsleeos@yuhs.ac.kr

Received 23 July 2009 Revised 26 April 2010 Accepted 18 June 2010

Abstract

Purpose

To investigate clinical and radiographic results for cementless total hip arthroplasty (THA) using ceramic-on-ceramic articulation in patients over 60 years old.

Materials and Methods

Between May 2000 and February 2007, we analyzed 44 THAs that used ceramic-on-ceramic articulation in 34 patients aged 60 or older. The mean follow-up duration was 3.2 years; the mean age was 66.8 years. Clinical and radiographic evaluations were carried out. Risk factors for dislocation were evaluated.

Results

Final Harris hip scores increased to an average of 90 points from an average of 51 points preoperatively. Radiographic findings demonstrated that fixations around the stems and the acetabular cups were stable. There was no aseptic loosening and osteolysis around the implants. There were 10 cases of posterior dislocation within 3 months postoperatively. Two revisions were done, one due to a recurrent dislocation and one to a ceramic head fracture. Risk factors for dislocation were ASA score, cup anteversion angle and total anteversion angle.

Conclusion

Cementless THAs using ceramic-on-ceramic articulation for patients aged sixty or more elicits good clinical and radiographic results. Because of the high rate of early dislocation and damage to the ceramic, we call attention to the position of the implants and postoperative management in elderly, debilitated patients.

Keywords: Total hip arthroplasty, Ceramic-on-ceramic, Dislocation

Figures and Tables

Fig. 1

(A) Seventy-four old male underwent total hip arthroplasty with ceramic on ceramic bearing surface for osteonecrosis of the right femoral head. ASA score was II. (B) Anteversion of the acetabular cup is 16 degree. (C) Even if surgeon's warning, he squatted 5th postoperative day. His right hip was dislocated three times recurrently within 2 weeks. (D) Finally, Revision total hip arthroplasty was done.

Fig. 2

Sixty-five year old male was performed total hip arthroplasty (A) At 15 months, follow-up radiograph shows the fracture of the ceramic femoral head. (B) Photograph shows the broken ceramic femoral head and slightly damaged acetabular liner. (C) Revision total hip arthroplasty was performed.

Table 1

Comparison between Dislocation Group and Control Group

(^*: p<0.05)

Table 2

Risk Factor of Dislocation

(^*: p<0.05)

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