Third-Generation Ceramic-on-Ceramic Total Hip Arthroplasty in Patients with Osteonecrosis of the Femoral Head
| Autor: | Hong Seok Kim, Yong-Chan Ha, Joo Hyung Ha, Kyung-Hoi Koo, Jung Wee Park, Young-Kyun Lee |
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| Rok vydání: | 2021 |
| Předmět: |
Male
musculoskeletal diseases Ceramics medicine.medical_specialty Osteolysis Arthroplasty Replacement Hip Prosthesis Design Femoral head Survivorship curve Aluminum Oxide medicine Humans Orthopedics and Sports Medicine In patient Ceramic Retrospective Studies business.industry Osteonecrosis Femur Head General Medicine medicine.disease Confidence interval Prosthesis Failure Surgery Treatment Outcome medicine.anatomical_structure Harris Hip Score Radiological weapon visual_art visual_art.visual_art_medium Female Hip Prosthesis business Follow-Up Studies |
| Zdroj: | Journal of Bone and Joint Surgery. 104:68-75 |
| ISSN: | 1535-1386 0021-9355 |
| DOI: | 10.2106/jbjs.20.00720 |
| Popis: | Background Long-term follow-up results of ceramic-on-ceramic (COC) total hip arthroplasty (THA), specifically, in patients with osteonecrosis of the femoral head (ONFH) are unknown. We evaluated (1) clinical results and radiological outcomes, (2) ceramic-related complications: noise and ceramic fracture, (3) osteolysis, and (4) survivorship after alumina COC THA in ONFH patients with longer than 10-year follow-up. Methods From May 2003 to June 2009, 325 ONFH patients (403 hips) underwent primary THAs at our department. Among them, 231 patients (293 THAs) were followed for 10 to 16 (mean, 12.9) years. There were 148 men and 83 women, their mean age at the time of THA was 47.2 years, and their mean body index was 24.0 kg/m2. The postoperative CT scans were done in 160 hips. Results Grinding sensation or squeak was noted in 6.8% (20/293), ceramic head fracture occurred in 2.4% (7/293) and acetabular osteolysis developed in 0.7% (2/293). All 7 ceramic fractures occurred in 28-mm short-neck heads. There was no detectable wear or prosthetic loosening, and the 16-year survivorship was 96.0% (95% confidence interval; 93.8% to 98.2%). The mean Harris hip score was 91.7 (range, 84 to 100) points at the final follow-up. Conclusions The 10- to 16-year results of alumina COC THAs were encouraging with an excellent survivorship. However, ceramic fracture and noise still remain matters of concern. We recommend not to use 28-mm short-neck ceramic head to avoid ceramic head fractures. Level of evidence III. |
| Databáze: | OpenAIRE |
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