Abstract
Hydroxyapatite Ceramic Coated Hips (HAC) were first used in Sunderland, U.K. in May 1988. More than 1725 HAC hips have been inserted. There are 264 hips in 237 patients with ceramic/ceramic (alumina) bearings.
These hips are inserted into patients with a 20+ year life expectancy. Their mean age is 50.5 years.
All patients are assessed using the Harris Hip Score pre. and postoperatively. There are 14 patients with Harris Hip Scores of less than 80, but only 8 patients have problems attributable to HAC hip surgery. These include 1 patient with infection, 3 fractured ceramic acetabular liners, one broken ceramic head, 2 with aseptic loosening and 1 patient who chronically dislocated her hip.
Amongst the indications were osteoarthritis 136, hip dysplasia 44, and ankylosing spondylitis 13. Twenty six had had previous childhood hip disorders, and 16 had rheumatoid arthritis. The series also includes 4 revisions from cemented hip replacement.
The results have been rewarding. There are 1700+ HAC hips in the whole series. This sub group of 264 ceramic/ceramic HAC hips is small and follow up is relatively short. There have been few failures which could be attributed to the HA coated device. However, there are 4 broken ceramic components.
Conclusion: Hydroxy Apatite bony bonding secures the implants. No polyethylene is used which can contribute to debris disease.
Wear in ceramic bearings will be negligible. Third body inclusions must be avoided.
The femoral spigot must not impinge on the acetabular margin. The ceramic material has to be supported to prevent fracture.
These abstracts were prepared by Mr Peter Kay. Correspondence should be addressed to him at The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.
