Primary Cementless Total Hip Arthroplasty with a Sandwich Type in Ceramic-Ceramic Articulation (Minimum 10-Year Follow up Results)

Ui Seoung Yoon; Hak Jin Min; Jae Sung Seo; Jin Soo Kim; Byung Ho Lim; Joon Yub Kim; Hyun Seok Oh; Ju Pil Seok; Seung Yub Baek

doi:10.5371/jkhs.2011.23.3.206

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Yoon, Min, Seo, Kim, Lim, Kim, Oh, Seok, and Baek: Primary Cementless Total Hip Arthroplasty with a Sandwich Type in Ceramic-Ceramic Articulation (Minimum 10-Year Follow up Results)

Original Article

The Journal of the Korean Hip Society

The Journal of the Korean Hip Society 2011; 23(3): 206-212.

Published online: 30 September 2011

DOI: https://doi.org/10.5371/jkhs.2011.23.3.206

Primary Cementless Total Hip Arthroplasty with a Sandwich Type in Ceramic-Ceramic Articulation (Minimum 10-Year Follow up Results)

Ui Seoung Yoon, MD, Hak Jin Min, MD, Jae Sung Seo, MD, Jin Soo Kim, MD, Byung Ho Lim, MD, Joon Yub Kim, MD, Hyun Seok Oh, MD, Ju Pil Seok, MD, Seung Yub Baek, MD

Department of Orthopedic Surgery, Seoul Medical Center, Seoul, Korea.

Address reprint request to: Seung Yub Baek, MD. Department of Orthopaedic Surgery, Seoul Medical Center, 316 Sinnae-dong, Jungnang-gu, Seoul 131-130, Korea. TEL: +82-2-2276-8515, FAX: +82-2-539-1262, syback@hanmail.net

Received 25 April 2011 Revised 7 September 2011 Accepted 14 September 2011

Abstract

Purpose

To evaluate the minimum 10-year follow up results of primary total hip arthroplasty (THA) performed using a sandwich-type (alumina-polyethylene-titanium) ceramic bearing.

Materials and Methods

Thirty four patients (40 hips) who underwent a THA with sandwich typed liners from November 1998 to December 2000 were analyzed. Among the 34 patients, 25 were men and nine were women. Mean follow-up was 134 months (range, 120~145 months) and mean patient age at the time of THA was 47.1 years (range, 24~65 years). The clinical results were evaluated using the Harris hip score and level of thigh pain with a limping gait. The radiographic evaluation was done in terms of the endosteal new bone formation, radiolucent line, subsidence of the stem, migration of the acetabular cup, and proof of loosening.

Results

The mean preoperative Harris hip score of 50.2 points (range, 31~87 points) was improved to 90.9 points (range, 75~99 points) at the final follow-up and thigh pain with limping gait in one case. All cases had fixation by bony ingrowth. No radiographically detectable loosening was observed in any hip. Fracture of ceramic liner in one case required change of the polyethylene liner.

Conclusion

At the minimum 10-year follow up, survival rate as the end-point was favorable. However, fracture of the ceramic is still a major problem. Satisfactory results can be obtained by more precise surgical technique for acerabular inclincation and anteversion, and by improving the quality of the ceramic.

Keywords: Total hip arthroplasty, Sandwich-typed, Ceramic-ceramic

Figures and Tables

Fig. 1

Anteroposterior radiograph of 61-years old male patient. 10 years follow-up radiograph shows endosteal new bone formation on Gruen Zone II (arrow). There was no osteolysis and loosening sign.

Fig. 2

Anteroposterior radiograph of 47-years old male patient. (A) At the 9 years 7 month follow-up, fractured ceramic liner was noted (arrow). (B) Postoperative radiograph of revision of ceramic liner.

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