Translating theoretical advantages of ceramics into excellent outcomes and long-term survivorship.
This is one of the conclusions of a single center study with modern alumina ceramic-on-ceramic bearings at a median follow up of over 15 years in hybrid THA in young and active patients under 65 years.
Farhan-Alanie et al (Glasgow, Royal Infirmary), examined patient data from 2004 to 2007 with modern ceramic bearings in primary hybrid THR (cemented stem with an uncemented shell (both Stryker)). For this study, the authors reviewed data from a total of 195 hips (175 patients; 112 female hips, 83 male hips) with regard to demographic data, surgical factors, clinical outcomes, radiographic results, and revisions. The median age of the observation group at surgery was 55 years. During the follow-up period, 23 patients (27 hips) died. The Oxford Hip Score (OHS) was used to assess the clinical data. At the median 15-year follow-up, the survival rate for all revisions from any cause was 97.2%.
During the follow-up period, 5 of 195 hips had to be revised
- 2 cases of infections
- 1 case of Iliopsoas Impingement
- 1 case of dislocation
- 1 case of squeaking. The revision was requested by the patient despite the fact that the squeaking was neither audible nor reproducible at the follow-up visits.
The authors observed for their series that the posterior approach and a head size of 32mm contributed to these favorable outcomes.
Worth mentioning: The authors report no ceramic component fractures for this series of 195 CoC THA and 3 ceramic component fractures out of 3,200 CoC THA performed in their unit over the last 16 years.
References: Omer M. H. Farhan‑Alanie, Alex Hrycaiczuk,Craig Tinning et al. Alumina ceramic‑on‑ceramic hybrid total hip arthroplasty. A median of 15 years follow‑up. 2021: European Journal of Orthopaedic Surgery & Traumatology.
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