Ceramic-on-Ceramic Bearing Total Hip Arthroplasty in Young Patients with Osteonecrosis of Femoral Head

Kim, Shin Yoon; Kim, Yong Gu; Yeo, Jun Young; Kim, Do Heon; Ihn, Joo Chul

Abstract

PURPOSE
To evaluate the short-term clinical and radiographic results associated with use of the ceramicon-ceramic articulation uncemented total hip arthroplasty (THA) in patients less than fifty years old with osteonecrosis of femoral head. MATERIALS AND METHODS: Sixty-eight THAs with use of the ceramic-on-ceramic articulation were performed in fifty-nine patients who were younger than fifty years old with the implantation of an uncemented plasma coated Plasma cup and Bicontact stem. All patients were available for complete clinical and radiographic analysis after a mean duration of a follow-up of 31.6 months (range; 24-50 months). The average age of the patients at the index operation was 39.4 years (range; 16-49 years). Preoperative diagnosis was osteonecrosis of femoral head in all hips. The causative factors were idiopathic in twenty-one hips; alcohol abuse in twenty-eight hips, steroid in eleven hips, and posttraumatic in eight hips. Clinical evaluation was done by Harris Hip score (HHS). Radiographic evaluation was done in terms of stability of components and prevalence of osteolysis. RESULTS: The mean preoperative HHS of 61 points improved to 95 points at the time of the final follow-up. Excellent results were found in 57 hips (84%), good results were 11 hips (16%). No acetabular or femoral components were loosened radiographically. There was no evidence of osteolysis. There were two postoperative dislocation, one intraoperative femoral fissuring, and one transient sciatic nerve palsy. CONCLUSION: Short-term clinical and radiographic results associated with use of the ceramic-on-ceramic articulation uncemented THA in patients less than fifty years old with osteonecrosis of femoral head were excellent. However, longer-term follow up is needed.