Abstract
Patients who are less than 50 years old at the time of total hip arthroplasty (THA) have been known to have higher failure rates than patients who are older. Wearinduced osteolysis and associated component loosening is the most common mode of failure reported. The current investigation prospectively assessed the survivorship and clinical results of alumina ceramic-ceramic THA in patients younger than 50 years.
238 consecutive hips in 201 patients treated by alumina ceramic-ceramic THA were studied. The mean age at operation was 41.4 ± 7.5 years (range, 18 – 50 years).
The preoperative Merle d’Aubigné score was 11.1 ± 1.6 (6 – 15). The preoperative diagnosis included primary osteoarthritis or impingement (105 hips, 44%), developmental dysplasia of the hip (90 hips, 38%), osteonecrosis of the femoral head (17 hips, 7%), post-traumatic osteoarthrosis (16 hips, 7%), and rheumatoid arthritis (6 hip, 3%). 144 hips (61%) were replaced with the use of surgical navigation for acetabular component positioning. The mean cup diameter was 51.8 ± 3.7 (range, 46 – 60 mm). 73 (31%) bearings were 28 mm and 165 (69%) bearings were 32 mm.
At mean follow-up of 5.6 ± 2.3 years (2 – 11 years), the mean Merle d’Aubigné score was 17.4 ± 0.9 (14 – 18). There were no radiographic signs of osteolysis. There were two revisions (0.8%): one for acute cup displacement and one for a ceramic liner fracture. In addition, one hip was treated by I& D for acute infection and another with I& D but without evidence of infection. Other complications included one greater trochanter fracture and one calcar fracture, both repaired at surgery, and one transient peroneal nerve palsy. The 10-year Kaplan Meier survivorship of the implants (revision of any component for any reason) was 98.7% (95% confidence interval 96.3–100%). There were no hip dislocations.
Results of THA in patients less than 50 years using alumina ceramic-ceramic bearings at two to eleven years follow-up are promising with no case of osteolysis or dislocation.
Correspondence should be addressed to Diane Przepiorski at ISTA, PO Box 6564, Auburn, CA 95604, USA. Phone: +1 916-454-9884; Fax: +1 916-454-9882; E-mail: ista@pacbell.net
