Alumina-on-Alumina THAin Active Patients Younger than 40 Years Old: A 5-Year Minimum Follow-Up Study

Yoo, Jeong Joon; Kim, Young Min; Yoon, Kang Sup; Koo, Kyung Hoi; Nam, Kwang Woo; Cho, Jai Ho; Kim, Hee Joong

Abstract

PURPOSE: Alumina-on-alumina bearing surfaces in total hip arthroplasties (THAs) are an attractive alternative coupling and may be a promising option for young active patients. This study evaluated the results of contemporary primary alumina-on-alumina cementless THAs performed in patients younger than 40 years.
MATERIALS AND METHODS
This study evaluated the results in a consecutive series of 72 alumina-on-alumina THAs performed in 61 patients who were younger than 40 years old (average, 30 years; range, 18-39 years) after a minimum 5-year follow-up (average, 69 months; range, 60-83 months).
RESULTS
The mean Harris hip score was 97.2 points at the latest follow-up. All the hips showed radiographic evidence of a bone ingrown prosthesis. No radiological loosening was found and no revision was required for either the stems or the cups. Ceramic wear was not detected in the 24 hips where differentiation of the femoral head was possible on radiographs, and no periprosthetic osteolysis was observed. A ceramic fracture after a major motor vehicle accident and an impingement-associated ceramic liner edge fracture for an inadequate abductor muscle tone occurred. During the follow-up period, no other ceramic fractures occurred as a result of normal everyday activity.
CONCLUSION
From the viewpoints of wear, osteolysis, and implant fixation, the results of the contemporary alumina-on-alumina THAs performed in younger active patients were encouraging at the 5-year minimum follow up. However, in order to minimize the possibility of modern ceramic failure, a careful preoperative patient evaluation to determine the proper indication for ceramic bearings, and meticulous surgical techniques are recommended.