J Korean Hip Soc.  2008 Jun;20(2):91-97. 10.5371/jkhs.2008.20.2.91.

Ceramic on Ceramic Hybrid Type Total Hip Arthroplasty in Patients with more than 65 years of Age -Minimum 5-year Follow-up Results

• Lee S
• Kim JH
• Ko DO
• Jeon YW
• Yang SJ
• Ryu CW

• KMID: 2162636
• DOI: http://doi.org/10.5371/jkhs.2008.20.2.91

Abstract

Purpose
This study examined the minimum five-year results of hybrid type total hip arthroplasty (THA) with ceramic-on-ceramic articulation and femoral stem fixation using cement in patients older than 65 years.
Materials and Methods
From February 1999 to November 2002, a hybrid type THA with ceramic-on-ceramic articulation and femoral stem fixation using cement were performed in 47 patients (47 hips) older than 65 years of age. Among the 47 patients, 29 patients were followed up for more than 5 years. The mean age of these patients was 68.9 years (65~73years). The mean follow-up period was 74.6 months (61~107 months). The postoperative diagnosis included AVN of the femoral head in 21 hips, Osteoarthritis in 2 hips, rhematoid arhthritis in 1 hip, femoral neck fracture in 4 hips and Tuberculosis in 1 hip. The clinical results were analyzed retrospectively by the Harris hip score (HHS), hip and thigh pain, and radiologically by the level of osteolysis around acetabular cup and femoral stem, bone reabsorption by stress shielding, instability, acetabular and femoral stem anteversion, acetabular inclination and the femoral stem fixation site.
Results
After surgery, the overall HHS improved from 56.3 +/- 1.4 to 92.3 +/- 1.1 points (p=0.013). Excellent and good results were obtained in 21 (72.4%) and 8 hips (27.6%), respectively. There was no case of thigh pain. Radiologically, there was no acetabular and femoral component osteolysis. Absorption by stress shielding was observed in 6 cases (20.7%) with an acetabular cup and 3 cases (10.3%) with a femoral stem. Bony stability was observed in all cases treated with an acetabular cup and possible loosening in 1 case (3.4%) treated with a femoral stem. Acetabular and femoral stem anteversion was 18.4degrees+/- 1.1 and 13.1degrees+/- 0.9 respectively. Acetabular inclination was 41.5degrees+/- 1.3. The femoral stem was inserted centrally in all cases. Complications included posterior dislocation of 1 hip (3.4%) and periprosthetic fracture of the femur in 1 hip (3.4%). There was no fracture of the ceramic component
Conclusion
The mid-term results of hybrid type THA with ceramic-on-ceramic articulation and femoral stem fixation using cement were effective both clinically and radiologically in patients older than 65 years.

Keyword

Hip; Total hip arthroplasty; Ceramic-on-ceramic; Hybrid type

MeSH Terms

Absorption
Arthroplasty
Ceramics
Chimera
Dislocations
Femoral Neck Fractures
Femur
Follow-Up Studies
Head
Hip
Humans
Osteoarthritis
Osteolysis
Periprosthetic Fractures
Retrospective Studies
Tacrine
Thigh
Tuberculosis
Ceramics
Tacrine