Ceramic on Sandwich Ceramic Bearing Primary Cementless Total Hip Arthroplasty (Result of 2 to 5 years follow up)

Hwang, Sung Kwan; Jeon, Jong Se; Lee, Byung Ho

Abstract

PURPOSE
To evaluate the short term clinical and radiological results of ceramic on sandwich ceramic bearing a primary cementless total hip arthroplasty. MATERIALS AND METHODS: Seventy-five hips, which underwent a total hip arthroplasty with sandwich typed liners as an index operation between December 1998 and October 2001 were examined. The mean follow-up period was 34.3 months, and the mean ages at surgery was 56. The clinical results were evaluated using the Harris hip score and the level of thigh pain. In addition, the radiolucent line, the subsidence of the stem, the migration of the acetabular cup, or osteolysis, proving and proof of loosening. RESULTS: The mean preoperative Harris hip score of 51.8 points was improved to 94.3 points at the final follow-up after surgery. Two cases were the fracture of ceramic components in postoperative three year. One of them was a fracture of the ceramic head and the other was a fracture and dislocation of the liner. Radiologically, there was one case of femoral stem subsidence and radiolucent line. CONCLUSION: The minimum 2-year clinical and radiological results of using ceramic sandwich ceramic bearing were satisfactory. However, breakages (fractures) of the ceramics have become an issue. Satisfactory clinical results can be obtained by limiting the acetabular inclination ranges from 40degrees to 45degrees, using a ceramic head with a larger diameter to increase the ratio between the diameter of the femoral head and neck, avoiding the use of a flange, reducing of the diameter of the femoral neck, the use of a thick-rimmed liner and improving the quality of the ceramic set. Therefore, the use of a sandwich ceramic liner needs to be reconsidered.