gms | German Medical Science

German Congress of Orthopedic and Trauma Surgery (DKOU 2017)

24.10. - 27.10.2017, Berlin

Midterm results of delta ceramic-on-ceramic total hip arthroplasty in patients with osteonecrosis of femroal head

Meeting Abstract

  • presenting/speaker Young-Kyun Lee - Seoul National University Bundang Hospital, Seongnam, Korea, Republic of (South Korea)
  • Woo-Lam Jo - Catholic University of Seoul, Korea, Seoul, Korea, Republic of (South Korea)
  • Jun-il Yoo - Seoul National University Bundang Hospital, Seongnam, Korea, Republic of (South Korea)
  • Byung-Ho Yoon - Inje University College of Medicine, Seoul, Korea, Republic of (South Korea)
  • Yong-Chan Ha - Chung-Ang University College of Medicine, Seoul, Korea, Republic of (South Korea)
  • Kyung-Hoi Koo - Seoul National University Bundang Hospital, Seongnam, Korea, Republic of (South Korea)

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017). Berlin, 24.-27.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocIN13-404

doi: 10.3205/17dkou021, urn:nbn:de:0183-17dkou0218

Published: October 23, 2017

© 2017 Lee et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives: Delta ceramic bearing was developed to reduce ceramic fracture. So far, some preliminary or retrospective studies reported similar or superior results of Delta ceramic total hip arthroplasty (THA) compared to earlier ceramics. We conducted a prospective study of Delta ceramic THA to determine the rate of ceramic fracture, to characterise postoperative noise, and to evaluate the midterm results and survivorship.

Methods: From March 2009 to March 2011, 151 patients (178 hips) underwent cementless THA with the use of Delta ceramic femoral head and liner. We used a porous-coated metal shell and a tapered hydroxyapatite-coated stem. In each follow-up, the clinical evaluation including noise and radiological evaluations were recorded. The Kaplan-Meier analysis was performed to estimate survival.

Results: Three patients (3 hips) died and 8 patients (10 hips) were lost within 5 years. The remaining 140 patients (165 hips) were followed for 60 to 84 months (mean, 68.0 months). There were 100 men (119 hips) and 40 women (46 hips) with a mean age of 46.5 years (range, 16 to 79) at surgery. The mean preoperative Harris hip score of 51.1 points improved to 94.2 points at the latest follow-up. Five patients reported squeaking in 5 hips. However, none had reproducible squeak. Radiolucent line involving Gruen zone 1 and/or 7 was seen in 29 hips (17.6%). No hip had detectable wear, focal osteolysis or prosthetic loosening. One hip was revised due to ceramic liner fracture, which occurred due to undetected malseating of the ceramic liner. One hip was revised due to periprosthetic femoral fracture, and one hip was treated for periprosthetic joint infection. The 6-year survivorship with a reoperation for any reason as the end point was 99.4% (95% confidence interval, 98.8%-100%).

Conclusions: The rate of Delta ceramic fracture in our patients was 0.6% (1/165). While ceramic head fracture was dominant in previous ceramic-on-ceramic THA, ceramic liner fracture, which is related with malseating, is a concern of the newest ceramic bearing THA.