PROSPECTIVE RANDOMISED TRIAL COMPARING ALUMINA-ALUMINA TO METAL-POLYETHYLENE BEARING SURFACES IN HYBRID TOTAL HIP ARTHROPLASTY.

Abstract

One hundred and forty eight hybrid total hip arthroplasties in patients less than seventy years old were randomised to metal on polyethylene or alumina on alumina bearing surfaces. At two to seven years of follow-up, no significant difference was found on hip scores or survivorship of the implants. No specific complication associated to alumina components like fracture or malpositionning of the acetabular insert were observed. Alumina on alumina bearing surfaces give early clinical and radiological results similar to metal on polyethylene, suggesting that they have a potential to become good bearing surfaces in hip arthroplasty for young patients.

The excellent results obtained with metal-polyethylene (M-P) bearing surfaces in total hip arthroplasty (THA) are still limited by the production of polyethylene wear debris, osteolysis and aseptic loosening. Because of it superior tribologic properties and bioinert composition, alumina-alumina (AL-AL) bearing surfaces are proposed to improve survival of THA but previously reported early complications prevented widespread use of alumina ceramic. This study compares early results and complication with Ceraver M-P and AL-AL THA.

One hundred forty-eight Ceraver hybrid THA in patients less than seventy years old were randomised to M-P or AL-AL bearing surfaces. We present the clinical and radiological results for patients two to seven years after their surgery.

No significant difference was found on W.O.M.A.C. and Merle D’Aubigné Postel scores. No specific complication associated with alumina components like fracture or malpositionning of the acetabular insert were observed in this study. Documented complications were: infection 4 AL-AL/2 M-P; dislocation 1 AL-AL/4 M-P; and heterotopic ossification 47% AL-AL/24% M-P. No aseptic loosening was observed.

Ceraver AL-AL bearing surfaces give early clinical and radiological results similar to M-P. Our results are in accordance with studies suggesting that AL-AL have a potential to become good bearing surfaces in THA in the young patients.

Funding: funding was obtained from Ceraver, Paris to perform this study.