MEDIUM-AND LONG-TERM effectiveness OF THIRD-GENERATION CERAMIC-ON-CERAMIC TOTAL HIP ARTHROPLASTY FOR END-STAGE HIP DISEASE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 HUANGXiaonan , ZHANGYong , WANGQi

Department of Orthopedic Surgery, Heze Municipal Hospital, Heze Shandong, 274031, P. R. China;

Corresponding author：

HUANGXiaonan, Email: 2987270765@qq.com

Keywords：

Total hip arthroplasty; Third-generation ceramic-on-ceramic hip prosthesis; Medium-and long-term effectiveness

DOI：

10.7507/1002-1892.20140148

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Objective To evaluate the medium-and long-term effectiveness of the 3rd-generation ceramic-on-ceramic total hip arthroplasty (THA) for end-stage hip disease. Methods A retrospective analysis was made on the clinical data of 142 patients (148 hips) who underwent the 3rd-generation ceramic-on-ceramic THA between May 2001 and May 2005. There were 78 males and 64 females, aged 57.2 years on average (range, 23-81 years). Preoperative diagnosis was avascular necrosis of femoral head in 73 patients (77 hips), degenerative osteoarthritis in 35 patients (36 hips), femoral neck fracture in 18 patients (18 hips), rheumatoid arthritis in 14 patients (15 hips), and septic hip sequelae in 2 patients (2 hips). The preoperative Harris hip score was 58.3±12.9. Results All incisions healed by first intention without complication. All patients were followed up 8.8 years on average (range, 7-12 years). At the last follow-up, the Harris hip score (92.5±10.2) was significantly higher than that at pre-operation (t=-25.29, P=0.00). At the last follow-up, there were 4 hips with groin pain, 6 hips with thigh pain. Complications occurred in 6 cases (6 hips), including loosening cups in 2 hips, hip dislocation in 2 hips, ceramic head fracture in 1 hip, and squeaking in 1 hip. The revision rate was 1.35% (3/148). X-ray film showed that acetabular cup loosening in 2 hips, discontinuous radiolucent line in 4 hips, and new bone formation in 88 hips; discontinuous radiolucent line around femoral component was observed in 25 hips, endosteal new bone formation in 95 hips, cortical bone hypertrophy in 2 hips, and femoral component subsidence in 9 hips (less than 2 mm). Conclusion Third-generation ceramic-on-ceramic THA is an effective treatment for end-stage hip disease, and can achieve satisfactory medium-and long-term effectiveness and a high implant survival rate.

Citation： HUANGXiaonan, ZHANGYong, WANGQi. MEDIUM-AND LONG-TERM effectiveness OF THIRD-GENERATION CERAMIC-ON-CERAMIC TOTAL HIP ARTHROPLASTY FOR END-STAGE HIP DISEASE. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(6): 669-672. doi: 10.7507/1002-1892.20140148 Copy

1.	徐勤, 贾铭, 史占军, 等. 陶瓷-陶瓷假体摩擦界面的人工全髋关节中期临床疗效随访研究. 中华临床医师杂志(电子版), 2013, 7(4):1538-1543.
2.	Choy WS, Kim KJ, Lee SK, et al. Ceramic-on-ceramic total hip arthroplasty:minimum of six-year follow-up study. Clin Orthop Surg, 2013, 5(3):174-179.
3.	Schmalzried TP, Jasty M, Harris WH. Periprosthetic bone loss in total hip arthroplasty. Polyethylene wear debris and the concept of the effective joint space. J Bone Joint Surg (Am), 1992, 74(6):849-863.
4.	Sedel L. Evolution of alumina-on-alumina implants:a review. Clin Orthop Relat Res, 2000, (379):48-54.
5.	蔡友治, 严世贵. 陶瓷人工关节研究进展. 中华骨科杂志, 2010, 30(11):1157-1160.
6.	Zha GC, Sun JY, Dong SJ. Less anterior knee pain with a routine lateral release in total knee arthroplasty without patellar resurfacing:a prospective, randomized study. Knee Surg Sports Traumatol Arthrosc, 2014, 22(3):517-525.
7.	DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res, 1976, (121):20-32.
8.	Gruen TA, McNeice GM, Amstutz HC. "Modes of failure" of cemented stem-type femoral components:a radiographic analysis of loosening. Clin Orthop Relat Res, 1979, (141):17-27.
9.	魏召劝, 孙俊英, 查国春, 等. 采用高交联聚乙烯与传统聚乙烯髋臼内衬行人工全髋关节置换的比较研究. 中国修复重建外科杂志, 2013, 27(12):1414-1418.
10.	Johanson PE, Digas G, Herberts P, et al. Highly crosslinked polyethylene does not reduce aseptic loosening in cemented THA 10-year findings of a randomized study. Clin Orthop Relat Res, 2012, 470(11):3083-3093.
11.	Mall NA, Nunley RM, Zhu JJ, et al. The incidence of acetabular osteolysis in young patients with conventional versus highly crosslinked polyethylene. Clin Orthop Relat Res, 2011, 469(2):372-381.
12.	Geerdink CH, Grimm B, Vencken W, et al. Cross-linked compared with historical polyethylene in THA:an 8-year clinical study. Clin Orthop Relat Res, 2009, 467(4):979-984.
13.	Matthies AK, Skinner JA, Osmani H, et al. Pseudotumors are common in well-positioned low-wearing metal-on-metal hips. Clin Orthop Relat Res, 2012, 470(7):1895-1906.
14.	D'Antonio JA, Capello WN, Naughton M. Ceramic bearings for total hip arthroplastyhave high survivorship at 10 years. Clin Orthop Relat Res, 2012, 470(2):373-381.
15.	沈锋, 唐昊, 黄建明, 等. 陶瓷-陶瓷全髋关节置换术中大小直径股骨头的早期比较. 中国矫形外科杂志, 2011, 19(6):463-467.
16.	仇志强, 廖琦. 陶瓷-陶瓷全髋关节置换术后髋关节"嘎吱"声现象的研究进展. 中华骨科杂志, 2012, 32(9):883-886.
17.	Willmann G. Ceramic femoral head retrieval data. Clin Orthop Relat Res, 2000, (379):22-28.
18.	Koo KH, Ha YC, Jung WH, et al. Isolated fracture of the ceramic head after third-generation alumina-on-alumina total hip arthroplasty. J Bone Joint Surg (Am), 2008, 90(2):329-336.
19.	Keurentjes JC, Kuipers RM, Wever DJ, et al. High incidence of squeaking in THAs with alumina ceramic-on-ceramic bearings. Clin Orthop Relat Res, 2008, 466(6):1438-1443.
20.	Lusty PJ, Tai CC, Sew-Hoy RP, et al. Third-generation alumina-on-alumina ceramic bearings in cementless total hip arthroplasty. J Bone Joint Surg (Am), 2007, 89(12):2676-2683.
21.	Walter WL, O'toole GC, Walter WK, et al. Squeaking in ceramic-on-ceramic hips:the importance of acetabular component orientation. J Arthroplasty, 2007, 22(4):496-503.
22.	Baek SH, Kim SY. Cementless total hip arthroplasty with alumina bearings in patients younger than fifty with femoral head osteonecrosis. J Bone Joint Surg (Am), 2008, 90(6):1314-1320.
23.	Mai K, Verioti C, Ezzet KA, et al. Incidence of "squeaking" after ceramic-on-ceramic total hip arthroplasty. Clin Orthop Relat Res, 2010, 468(2):413-417.
24.	Taylor S, Manley MT, Sutton K. The role of stripe wear in causing acoustic emissions from alumina ceramic-on-ceramic bearings. J Arthroplasty, 2007, 22(7 Suppl 3):47-51.
25.	McCollum DE, Gray WJ. Dislocation after total hip arthroplasty. Causes and prevention. Clin Orthop Relat Res, 1990, (261):159-170.

1. 徐勤, 贾铭, 史占军, 等. 陶瓷-陶瓷假体摩擦界面的人工全髋关节中期临床疗效随访研究. 中华临床医师杂志(电子版), 2013, 7(4):1538-1543.
2. Choy WS, Kim KJ, Lee SK, et al. Ceramic-on-ceramic total hip arthroplasty:minimum of six-year follow-up study. Clin Orthop Surg, 2013, 5(3):174-179.
3. Schmalzried TP, Jasty M, Harris WH. Periprosthetic bone loss in total hip arthroplasty. Polyethylene wear debris and the concept of the effective joint space. J Bone Joint Surg (Am), 1992, 74(6):849-863.
4. Sedel L. Evolution of alumina-on-alumina implants:a review. Clin Orthop Relat Res, 2000, (379):48-54.
5. 蔡友治, 严世贵. 陶瓷人工关节研究进展. 中华骨科杂志, 2010, 30(11):1157-1160.
6. Zha GC, Sun JY, Dong SJ. Less anterior knee pain with a routine lateral release in total knee arthroplasty without patellar resurfacing:a prospective, randomized study. Knee Surg Sports Traumatol Arthrosc, 2014, 22(3):517-525.
7. DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res, 1976, (121):20-32.
8. Gruen TA, McNeice GM, Amstutz HC. "Modes of failure" of cemented stem-type femoral components:a radiographic analysis of loosening. Clin Orthop Relat Res, 1979, (141):17-27.
9. 魏召劝, 孙俊英, 查国春, 等. 采用高交联聚乙烯与传统聚乙烯髋臼内衬行人工全髋关节置换的比较研究. 中国修复重建外科杂志, 2013, 27(12):1414-1418.
10. Johanson PE, Digas G, Herberts P, et al. Highly crosslinked polyethylene does not reduce aseptic loosening in cemented THA 10-year findings of a randomized study. Clin Orthop Relat Res, 2012, 470(11):3083-3093.
11. Mall NA, Nunley RM, Zhu JJ, et al. The incidence of acetabular osteolysis in young patients with conventional versus highly crosslinked polyethylene. Clin Orthop Relat Res, 2011, 469(2):372-381.
12. Geerdink CH, Grimm B, Vencken W, et al. Cross-linked compared with historical polyethylene in THA:an 8-year clinical study. Clin Orthop Relat Res, 2009, 467(4):979-984.
13. Matthies AK, Skinner JA, Osmani H, et al. Pseudotumors are common in well-positioned low-wearing metal-on-metal hips. Clin Orthop Relat Res, 2012, 470(7):1895-1906.
14. D'Antonio JA, Capello WN, Naughton M. Ceramic bearings for total hip arthroplastyhave high survivorship at 10 years. Clin Orthop Relat Res, 2012, 470(2):373-381.
15. 沈锋, 唐昊, 黄建明, 等. 陶瓷-陶瓷全髋关节置换术中大小直径股骨头的早期比较. 中国矫形外科杂志, 2011, 19(6):463-467.
16. 仇志强, 廖琦. 陶瓷-陶瓷全髋关节置换术后髋关节"嘎吱"声现象的研究进展. 中华骨科杂志, 2012, 32(9):883-886.
17. Willmann G. Ceramic femoral head retrieval data. Clin Orthop Relat Res, 2000, (379):22-28.
18. Koo KH, Ha YC, Jung WH, et al. Isolated fracture of the ceramic head after third-generation alumina-on-alumina total hip arthroplasty. J Bone Joint Surg (Am), 2008, 90(2):329-336.
19. Keurentjes JC, Kuipers RM, Wever DJ, et al. High incidence of squeaking in THAs with alumina ceramic-on-ceramic bearings. Clin Orthop Relat Res, 2008, 466(6):1438-1443.
20. Lusty PJ, Tai CC, Sew-Hoy RP, et al. Third-generation alumina-on-alumina ceramic bearings in cementless total hip arthroplasty. J Bone Joint Surg (Am), 2007, 89(12):2676-2683.
21. Walter WL, O'toole GC, Walter WK, et al. Squeaking in ceramic-on-ceramic hips:the importance of acetabular component orientation. J Arthroplasty, 2007, 22(4):496-503.
22. Baek SH, Kim SY. Cementless total hip arthroplasty with alumina bearings in patients younger than fifty with femoral head osteonecrosis. J Bone Joint Surg (Am), 2008, 90(6):1314-1320.
23. Mai K, Verioti C, Ezzet KA, et al. Incidence of "squeaking" after ceramic-on-ceramic total hip arthroplasty. Clin Orthop Relat Res, 2010, 468(2):413-417.
24. Taylor S, Manley MT, Sutton K. The role of stripe wear in causing acoustic emissions from alumina ceramic-on-ceramic bearings. J Arthroplasty, 2007, 22(7 Suppl 3):47-51.
25. McCollum DE, Gray WJ. Dislocation after total hip arthroplasty. Causes and prevention. Clin Orthop Relat Res, 1990, (261):159-170.

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MEDIUM-AND LONG-TERM effectiveness OF THIRD-GENERATION CERAMIC-ON-CERAMIC TOTAL HIP ARTHROPLASTY FOR END-STAGE HIP DISEASE

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