Hip Pelvis.  2014 Mar;26(1):14-21. 10.5371/hp.2014.26.1.14.

Primary Cementless Total Hip Arthroplasty with a Ceramic Sandwich Liner and a Third Zweymuller Stem: Minimum 8-Year Follow up Results

• Moon DH
• Kim NK
• Wang IW
• Lee SJ
• Choi JS

• KMID: 2054157
• DOI: http://doi.org/10.5371/hp.2014.26.1.14

Abstract

PURPOSE
The purpose of this study is to evaluate the minimum eight-year follow up results of primary total hip arthroplasty (THA) performed using an alumina sandwich liner and the third Zweymuller stem.
MATERIALS AND METHODS
A total of 86 patients (107 hips) who underwent a THA with alumina sandwich liners and the third Zweymuller stems from July 2001 to December 2003 were analyzed. Mean age of patients at the time of THA was 50.8 years (range, 17-77 years) and the mean follow-up period was 112 months (range, 98-127 months). Clinical evaluation was performed using the Harris hip score and level of thigh pain. The radiographic evaluation was performed in terms of the radiolucent line, subsidence of the stem, migration of the acetabular cup, and proof of loosening.
RESULTS
At the final follow-up, mean Harris hip score had improved from 57.8 points to 91.9 points. Radiolucent line was observed at Gruen zone 1 in 40 cases (37%) and at zone 7 in 35 cases (33%); however, no detectable loosening was observed. There were six cases (5.6%) of fracture of the ceramic liner, one case of ceramic liner dissociation, and one case of stem loosening due to infection.
CONCLUSION
At the minimum eight-year follow up, survival rate of the third Zweymuller stem was 99.1%. However, owing to the high rate of fractures of the ceramic sandwich liners, the survival rate of the ceramic liner was 93.5%.

Keyword

Total hip arthroplasty; Ceramic sandwich liner; Zweymuller stem

MeSH Terms

Acetabulum
Aluminum Oxide
Arthroplasty, Replacement, Hip*
Ceramics*
Follow-Up Studies*
Hip
Humans
Survival Rate
Thigh
Aluminum Oxide
Ceramics

Figure

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  Fig. 1 (A) Radiographs show broken pieces around femoral stem (arrows). (B) Photographs show a fractured ceramic liner. Ceramic liner was broken in mutiple pieces. (C) Radiographs after acetabular cup, polyethylene liner and ceramic head changed.

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  Fig. 2 (A) Anteroposterior radiograph shows a dissociated ceramic liner from polyethylen (arrow). (B) Lateral radiograph shows a dissociated ceramic liner from polyethylen (arrow). (C) Photographs showing a dissociated ceramic liner. Ceramic liner was not broken.

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  Fig. 3 (A) Anteroposterior radiograph after acetabular cup, polyethylene liner and ceramic head changed. (B) Translateral radiograph after acetabular cup, polyethylene liner and ceramic head changed.

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  Fig. 4 Survivorship analysis with sandwich liner removal for any cause as endpoint.

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  Fig. 5 Survivorship analysis with femoral stem removal for any cause as endpoint.

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