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Nine years follow-up of 100 ceramic-on-ceramic total hip arthroplasty
Christophe Chevillotte1, Vincent Pibarot, Jean-Paul Carret
1Department of Orthopedic Surgery, Pavillon T, Hôpital Edouard Herriot, 5 Place d'Arsonval, 69437, Lyon Cedex 03, France. christophe.chevillotte@chu-lyon.fr
Insights
This study found that cementless ceramic-on-ceramic total hip arthroplasty (THA) significantly improved patient hip scores after nine years. While some osteolysis occurred, revision rates remained low, supporting its use in active patients.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Total hip arthroplasty (THA) is a common procedure for hip joint degeneration.
- Ceramic-on-ceramic bearings offer potential advantages in THA, including wear resistance.
- Cementless fixation is increasingly used in THA for younger, active patients.
Purpose of the Study:
- To evaluate the long-term clinical and radiological outcomes of cementless ceramic-on-ceramic total hip arthroplasty (THA).
- To assess the efficacy and safety of this implant type in a cohort of patients.
Main Methods:
- A retrospective review of the first 100 cementless ceramic-on-ceramic THA cases at the institution.
- Clinical assessment using the Harris hip score.
- Radiological evaluation by two independent surgeons.
- Follow-up exceeding nine years.
Main Results:
- Significant improvement in Harris hip scores at the latest follow-up.
- Calcar osteolysis observed in 75% of patients.
- One case of cup loosening requiring revision surgery five years postoperatively.
- Low overall revision rate.
Conclusions:
- Cementless ceramic-on-ceramic THA demonstrates favorable long-term clinical outcomes with improved hip function.
- While calcar osteolysis is common, it did not significantly impact outcomes in most cases.
- The use of uncemented hydroxyapatite-coated ceramic-on-ceramic THA is advocated for young, active patients, especially when utilizing navigation systems for optimal implant positioning.
Abstract:
The aim of this study was to evaluate the first 100 cementless ceramic-on-ceramic total hip arthroplasty (THA) performed at our institution with more than nine years of follow-up. Clinical evaluation was performed using Harris hip score. Radiological evaluation was performed by two surgeons. Four patients were lost to follow-up. Harris hip score significantly improved at latest follow-up. Radiological analysis showed calcar osteolysis for 75 patients and one cup loosening. One patient required a revision five years postoperatively for cup loosening. Based on these results and the routine use of a navigation system to optimise positioning of the implants, we advocate the use of uncemented hydroxyapatite coated ceramic-on-ceramic THA in young and active patients in our current practice.