Abstract
Alumina-on-alumina bearings in total hip arthroplasty (THA) were introduced about 30 years ago. Theoretically, their excellent tribological properties and low debris generation provide a solution to osteolysis. The 24-year experience of the Paris group suggests that osteolysis is no longer a problem. Any need for revision was related to mechanical failure rather than to debris, except in a few cases in which a pros-thesis that had been loose for many years resulting in metal-on-ceramic impingement.
Cemented socket and screw-in ring metal-backed alumina yielded poor results. The recent improvements in alumina quality and in ceramic fixation, using cementless fully coated hydroxyapatite material, may provide a solution in active young patients. Preliminary results of the first 100 THA procedures using a cementless stem and socket and 32-mm alumina head, and alumina liner secured with a Morse taper, are very encouraging. One socket required revision because of poor initial surgery in a severe acetabular fracture. Patients ranged in age from 14 to 71 years (median 45 years).
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at The Department of Orthopaedic Surgery, Medical School, University of Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193 South Africa
