Ceramic endoprosthesis in total hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Clinical Research

Background:

• Total hip arthroplasty (THA) is a common procedure for hip joint pathologies.
• Aluminia-on-aluminia bearings and titanium alloy stems are used in hip prostheses.
• Acetabular component fixation (cemented vs. uncemented) is a critical factor in THA outcomes.

Purpose of the Study:

• To evaluate the clinical outcomes and revision rates of aluminia-on-aluminia hip prostheses with titanium alloy stems.
• To compare the performance of cemented versus uncemented acetabular cups in primary THA.
• To identify the main indications for revision surgery in this cohort.

Main Methods:

• Retrospective analysis of 255 primary total hip arthroplasties using aluminia-on-aluminia bearings and titanium alloy stems.
• Patients were divided into two groups: 143 with cemented acetabular cups and 112 with uncemented screw cups.
• Clinical data included personal examinations and radiographic studies; revision surgery was considered a failure.

Main Results:

• The cemented acetabular cup group (n=143) had a mean follow-up of 6.7 years, with a 11% revision rate (16/143).
• Aseptic loosening due to broken acrylic cement was the primary reason for revision in the cemented group (12/16).
• The uncemented screw cup group (n=112) had a mean follow-up of 3.6 years, with a 7% revision rate (7/112). Indications included infection, technical failure, and PVNS.

Conclusions:

• Cemented acetabular cups in this series demonstrated a higher revision rate compared to uncemented cups, largely attributed to cement failure.
• Uncemented acetabular components showed promising results with a lower revision rate in the observed follow-up period.
• Further investigation into cementless acetabular component fixation, including bone grafting, may be warranted for long-term stability.