Hip Pelvis.  2018 Mar;30(1):12-17. 10.5371/hp.2018.30.1.12.

Short-term Outcomes of Ceramic Coated Metal-on-Metal Large Head in Total Hip Replacement Arthroplasty

• Kim WY
• Ko MS
• Lee SW
• Kim KS

• KMID: 2408180
• DOI: http://doi.org/10.5371/hp.2018.30.1.12

Abstract

PURPOSE
This study characterizes the short-term outcomes of ceramic coated metal-on-metal (MoM) large head total hip arthroplasty (THA) in prospectively selected patients aged 70 to 75 years.
MATERIALS AND METHODS
Eighteen patients (18 hips) between the ages of 70 and 75-years old with THA using ceramic-coated MoM large heads between June 2014 and December 2014 were evaluated. We prospectively selected patients younger than 70 years for bipolar hemiarthroplasty and older than 75 years for conventional THA. There were one case of osteoarthritis, 8 cases of femur neck fracture, and 9 cases of intertrochanteric fracture. All patients underwent clinical and radiological follow-up at 6 weeks, 6 and 12 months, and every year postoperatively. The mean duration of follow-up was 24.2 months (range, 18-34 months).
RESULTS
The average Harris hip score at the final follow-up was 81.0, except one case which was ultimately converted to conventional THA due to acetabular cup loosening. Radiographically, mean acetabular cup inclination was 45.8°(range, 38-56°) and anteversion was 20.1° (range, 11-25°). The average femoral head size was 48.7 mm. All stems were neutral-positioned except 1 varus-positioned stem. There was 1 case of a soft tissue infection, 3 patients complained of persistent groin pain, and no dislocations occurred.
CONCLUSION
Ceramic coated large MOM articulation (ACCIS) have many complications: cup loosening, groin pain, which can lead to fatal outcomes in the elderly patients. Especially in patients with communicated intertrochanter fracture (AO 31-A22, 23), careful attention should be paid to the choice of surgical option.

Keyword

Hip replacement arthroplasty; Metal-on-metal articulation; Large femoral head; Complication

MeSH Terms

Acetabulum
Aged
Arthroplasty*
Arthroplasty, Replacement, Hip*
Ceramics*
Dislocations
Fatal Outcome
Femoral Neck Fractures
Follow-Up Studies
Groin
Head*
Hemiarthroplasty
Hip
Humans
Osteoarthritis
Prospective Studies
Soft Tissue Infections

Figure

• 

  Fig. 1 Acetabular component design. Polar area: no contact between the bone and the component. Fit area: contact with the porous coated surface for bone ingrowth. Press fit area: circumferential press fit at the equator for primary implant stability.

• 

  Fig. 2 Femoral heads and cone adapters. Each adapter is available in three different neck lengths in 4 mm increments and adapters are suited for femoral components with a 12/14 mm cone.

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