J Korean Orthop Assoc.  2013 Jun;48(3):190-196. 10.4055/jkoa.2013.48.3.190.

Early Results of Cementless Total Hip Arthroplasty Using a Third Generation Alumina-on-Alumina Bearing Surface

• Lee JC
• Baek SG
• Kim SY

• KMID: 2106672
• DOI: http://doi.org/10.4055/jkoa.2013.48.3.190

Abstract

PURPOSE
The purpose of this study is to evaluate the early results and occurrence of complications of cementless total hip arthroplasty (THA) using an alumina-on-alumina articulation with a minimum follow up period of three years.
MATERIALS AND METHODS
We prospectively followed 108 patients (121 hips) who underwent cementless THA using an alumina-on-alumina articulation. The mean age of the patients was 50.7 years (range, 20-80 years) and mean the follow up period was 48 months (range, 36-60 months). Preoperative diagnoses included osteonecrosis of the femoral head in 90 hips; secondary osteoarthritis due to hip dysplasia in 24 hips; secondary osteoarthritis after acetabular fracture in four hips; acute femoral neck fracture in three hips. Clinical evaluation was performed using Harris hip score (HHS) and radiographic evaluation was performed in terms of the fixation of components and the prevalence of osteolysis. In addition, we observed complications, including the occurrence of sound or fracture of the alumina head or liner.
RESULTS
Mean HHS improved from 62.4 points to 94 points at final follow-up. Thigh discomfort was found in six hips and mild inguinal discomfort was found in eight hips. Both had disappeared within one year after operation. A clicking sound was detected in two patients. One hip had become dislocated and an alumina liner fracture had occurred in one hip. Loosening of component or osteolysis was not observed in any hip. The radiographic wear was not measurable.
CONCLUSION
Early results of cementless THA using an alumina-on-alumina articulation were favorable, with osseointegration of the components and absence of periprosthetic osteolysis. However, longer-term follow up for a hip clicking sound and fracture of an alumina fracture are necessary.

Keyword

hip; total hip arthroplasty; alumina-on-alumina articulation

MeSH Terms

Aluminum Oxide
Arthroplasty
Femoral Neck Fractures
Follow-Up Studies
Head
Hip
Humans
Osseointegration
Osteoarthritis
Osteolysis
Osteonecrosis
Prevalence
Prospective Studies
Tacrine
Thigh
Ursidae
Aluminum Oxide
Tacrine

Figure

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  Figure 1 Photograph showing the COREN Hip System® with alumina-on-alumina bearing.

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  Figure 2 Anteroposterior radiographs showing the right hip of a 61-year-old female who underwent a total hip arthroplasty. (A) The preoperative findings of the secondary osteoarthritis due to hip dysplasia. (B) Postoperative 1-year follow-up radiograph. (C) Radiograph taken 48 months after total hip arthroplasty. Patient complained intermittent clicking of hip joint, but radiograph shows well fixed components without loosening.

• 

  Figure 3 Anteroposterior radiographs showing the right hip of a 51-year-old female who underwent a total hip arthroplasty. (A) The preoperative findings of hip dysplasia. (B) Postoperative 4-year follow-up radiogarph of fractured ceramic bearings. (C) Radiograph taken 2 months after head and liner change.

• 

  Figure 4 Photograph of the fractured alumina bearings. Photograph shows a fractured alumina liner (black arrows) and black discoloration of the alumina head (white arrow) that was retrieved form a 51-year-old female patient at 51 months postoperatively.

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