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BMC Musculoskelet Disord. 2015 Sep 12;16:249. doi: 10.1186/s12891-015-0703-2.

Long-term durability of alumina ceramic heads in THA.

Author information

1
Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200A, 69118, Heidelberg, Germany. nicholas.beckmann@med.uni-heidelberg.de.
2
Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200A, 69118, Heidelberg, Germany. tobias.gotterbarm@med.uni-heidelberg.de.
3
Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200A, 69118, Heidelberg, Germany. moritz.innmann@med.uni-heidelberg.de.
4
Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200A, 69118, Heidelberg, Germany. christian.merle@med.uni-heidelberg.de.
5
Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 305, 69120, Heidelberg, Germany. bruckner@imbi.uni-heidelberg.de.
6
Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200A, 69118, Heidelberg, Germany. philippe.kretzer@med.uni-heidelberg.de.
7
Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200A, 69118, Heidelberg, Germany. marcus.streit@med.uni-heidelberg.de.

Abstract

BACKGROUND:

The optimal type of bearing for hip arthroplasty remains a matter of debate. Ceramic-on-polyethylene (CoP) bearings are frequently used in younger and more active patients to reduce wear and increase biocompatibility compared to Metal-on-Polyethylene (MoP) bearings. However, in comparison to metal heads, the fracture risk of ceramic heads is higher. In addition, ceramic head fractures pose a serious complication which often necessitates major revision surgery. To date, there are no long-term data (>20 years of follow-up) reporting fracture rates of the ceramic femoral heads in CoP bearings. The purpose of this research was to investigate long-term CoP fracture rate.

METHODS:

We evaluated the clinical and radiographic results of 348 cementless THAs treated with 2nd generation Biolox Al₂O₃ Ceramic-on-Polyethylene (CoP) bearings consecutively implanted between January 1985 and December 1989. The mean age at implantation was 57 years. The patients were followed for a minimum of 20 years. At the final 111 had died, and 5 were lost to follow-up. The cumulative incidence of ceramic head fractures in the long-term was estimated using a competing risk analysis.

RESULTS:

The cumulative incidence of ceramic head fracture after 22-years was estimated with a competing risk analysis at 0.29% after 22-years (SE = 2.09%; 95% - CI: 0.03-1.5%). The radiographic analysis revealed no impending failures at final follow-up.

DISCUSSION/CONCLUSION:

The fracture rate of second-generation ceramic heads using a CoP articulation remains very low into the third decade after cementless THA.

PMID:
26363981
PMCID:
PMC4567834
DOI:
10.1186/s12891-015-0703-2
[Indexed for MEDLINE]
Free PMC Article

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