Use of bearings with integrated ceramic insert in cementless total hip arthroplasty – a preliminary report

Ceramic-on-ceramic articulation presents advancement in the development modern of hip prostheses. It is particularly important for young patients, in whom complications related with polyethylene damages and metalosis pose a serious clinical problem due to the long period of implant functioning. The aim of this study was to assess the effect of total cementless hip replacement using an implant with a ceramic insert embedded in a metal cup and large prosthetic head constituting a ceramic-on-ceramic system in patients with hip osteoarthritis.

During years 2012-2013 there were 26 total hip replacements in 24 patients with use of integrated ceramic cup at Department of Orthopedic and Traumatology of the Central Clinical Hospital of Ministry of Interior, Warsaw. We assessed clinical and radiological outcomes of this procedure using HHS (Harris Hip Score), WOMAC (The Western Ontario and McMaster Universities Arthritis Index) and NRS (Numeric Rating Scale) scores.

In our study group patients presented with a significant degree of improvement in passive range of motion in the hip joint and no postoperative complications were noted. Significant statistical improvement was noted after surgery in each of the following scales HHS (50.84 vs. 87.16), WOMAC (51.01 vs. 91.88) and NRS (6.8 vs. 0.45). There were no signs of early or radiological evidence of loosening and implant migration among our patients.

Cementless total hip arthroplasty using an acetabular component with a ceramic insert embedded in metal and a large prosthetic head (a ceramic-on-ceramic system) is an effective and a noteworthy method of treatment of hip osteoarthritis in young people.