Hip Pelvis.  2014 Jun;26(2):84-91. 10.5371/hp.2014.26.2.84.

Primary Total Hip Arthroplasty Using Third Generation Ceramic-Ceramic Articulation: Results after a Minimum of Three-years of Follow-up

• Lee DW
• Hwang SK

• KMID: 2054169
• DOI: http://doi.org/10.5371/hp.2014.26.2.84

Abstract

PURPOSE
This study assessed the short term clinicoradiological results of primary total hip arthroplasty using third generation ceramic-ceramic articulation Accolade TMZF femoral stems.
MATERIALS AND METHODS
Two hundred and seventy two patients (294 hips) with primary total hip arthroplasty using third generation ceramic-ceramic articulation Accolade TMZF femoral stems who had been followed-up for a minimum of 3 years were included. Clinicoradiological results were analyzed and postoperative complications were observed.
RESULTS
At final follow-up, mean Harris hip score was increased from 52 to 94 points. On radiogical evaluation, the average acetabular inclination was 42 degrees and the average acetabular anteversion was 15 degrees. Neither osteolysis nor loosening were observed around the acetabulum or proximal femur. Among 294 acetabular cups, 293 cups (99.66%) achieved stable fixation. Regarding the 294 femoral stems, 286 (97.28%) had bony fixation, 7 (2.38%) had fibrous fixation, and none were found to have unstable stem fixation. Proximal bone resorption was observed in 17 hips (5.78%; only Grade 1) and radiolucent lines were observed in 88 hips (29.93%), however, all were around the distal smooth portion of the stems. Postoperative complications included dislocation in 6 hips (2.04%), heterotopic ossification in 3 hips (1.02%), ceramic fractures in 4 hips (1.36%), superficial infection in 1 hip (0.34%), and squeaking in 8 hips (2.72%).
CONCLUSION
The short term clinicoradiological results of primary total hip arthroplasty using third generation ceramic-ceramic articulation and Accolade TMZF femoral stems together with Secur-Fit acetabular cups were satisfactory. However, problems such as ceramic fractures and squeaking after arthroplasty were observed. Additional studies are necessary in order to develop methods that may reduce or eliminate these complications.

Keyword

Third generation ceramic-ceramic articulation; Primary total hip arthroplasty; Harris hip score

MeSH Terms

Acetabulum
Arthroplasty
Arthroplasty, Replacement, Hip*
Bone Resorption
Ceramics
Dislocations
Femur
Follow-Up Studies*
Hip
Humans
Ossification, Heterotopic
Osteolysis
Postoperative Complications
Ceramics

Figure

• 

  Fig. 1 (A) This anteroposterior radiography shows avascular necrosis of the femoral head in a 47-year-old male. (B) The immediate postoperative radiography shows good positioning of the prosthesis. (C) After 6 years, the radiograph shows no osteolysis around the right acetabular and femoral component, and stable components with proper bony ingrowth.

• 

  Fig. 2 (A) This immediate postoperative radiography shows total hip arthroplasty with the Accolade hip system in a 47-year-old male. (B) After 2 years, the radiography shows ceramic fracture and dissociation, as well as some alumina chips around the neck of the stem. (C) The ceramic head and liner were replaced.

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