Use of ceramic-on-ceramic bearing in total hip arthroplasty for posttraumatic arthritis of the hip

We aimed to evaluate (1) the intraoperative parameters, (2) cup position, (3) complications, (4) long-term results, and (5) the survivorship of cementless total hip arthroplastys (THAs) with use of ceramic bearings in patients with a history of acetabular fracture.

We compared 57 THAs in patients, who were treated due to previous acetabular fracture (posttraumatic group), with 57 propensity score-matched THAs in patients, who were operated due to femoral head osteonecrosis (osteonecrotic group), at a minimum of 5-year follow-up.

The operation time was longer ( p = 0.008), and the volume of transfusion was larger ( p = 0.0.23) in the posttraumatic group. The cup abduction (39.4° ± 6.0° vs. 39.7°±4.8°) and anteversion (24.7° ± 8.0° vs. 26.7°±7.7°) were similar between the two groups. There was one dislocation in the posttraumatic group. There was no ceramic fracture in either group. One posttraumatic patient underwent excision of exuberant heterotrophic ossification at 3 years after the arthroplasty. The mean University of California, Los Angeles activity improved from 3.6 to 4.9 points in the posttraumatic group and 3.5 to 5.2 points in the osteonecrotic group. All acetabular cups and femoral stems had bone-ingrown stability. When reoperation for any reason was used as the end point, the 10-year survival rate was 98.3% (95% CI: 95.0-100) in the posttraumatic group and 100% in the osteonecrotic group.

In our study, posttraumatic patients had longer operation time and larger volume of transfusion than osteonecrotic patients. However, medium-term results and survivorship were similar with those of osteonecrotic patients.