Hip Pelvis.  2015 Dec;27(4):223-231. 10.5371/hp.2015.27.4.223.

Cementless Revision Total Hip Arthroplasty with Ceramic Articulation

• Yang JH
• Yang SJ
• Kang JS
• Moon KH

• KMID: 2150510
• DOI: http://doi.org/10.5371/hp.2015.27.4.223

Abstract

PURPOSE
The results of ceramic-on-ceramic (CoC) bearing surfaces in primary total hip arthroplasty (THA) were well known. However, it was not known in revision THA. The purpose of this study is to report the results of revision THA with ceramic articulation.
MATERIALS AND METHODS
A total of 112 revision THAs were evaluated. The mean age at the time of surgery was 51.6 years (27.7 to 84.2 years). The mean duration of the follow-up periods was 6.3 years (2.3 to 11.4 years).
RESULTS
The Harris hip scores improved from an average of 56.2 at the index surgery to an average of 93.3 at the last follow-up (P<0.001). None of hips showed osteolysis or ceramic head fracture. One hip showed aseptic loosening in the acetabular component with squeaking that caused a re-revision. There were nine cases of dislocation. The survivorship at 5 years was 94.5% (95% confidence interval, 87.9% to 97.6%) with revision for any reason as the endpoint and 100% with femoral revision.
CONCLUSION
The ceramic articulation is one of good bearing options for revision THA in patients with a long life expectancy.

Keyword

Revision total hip arthroplasty; Ceramic articulation

MeSH Terms

Acetabulum
Arthroplasty, Replacement, Hip*
Ceramics*
Dislocations
Follow-Up Studies
Head
Hip
Humans
Life Expectancy
Osteolysis
Survival Rate
Ceramics

Figure

• 

  Fig. 1 Anteroposterior radiographs showing the hip implant with loosening due to collapse of the structural bone graft. The loosening occurred six years after the revision, and the cup showed 3 mm migration, and 16° change in tilting. An allo-femoral head structural bone graft was used to replace the extensive osteolytic lesion, which was type IIIB defect according to the Paprosky's classification of bone defects. One year postoperatively there had been no further complications. (A) Postoperative radiograph after the first revision arthroplasty. (B) Follow-up radiograph 72 months after first revision arthroplasty. (C) Postoperative radiograph after the re-revision.

• 

  Fig. 2 Anteroposterior radiographs showing the hip implant with dislocation. The dislocation occurred three years after the revision. One year postoperatively there had been no further complications. (A) Postoperative radiograph after the first revision arthroplasty. (B) Follow-up radiograph 36 months after first revision arthroplasty. (C) Postoperative radiograph after the re-revision.

• 

  Fig. 3 Kaplan-Meier survival with 95% confidence intervals, with revision for any reason as the endpoint. The survivorships of 5 years and 10 years were 94.5% and 92.9%, respectively.

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