Review of patients at or under the age of fifty having total hip replacement using hydroxyapatite ceramic coated hip implants: a clinical and radiological evaluation with up to nineteen year follow-up

J Buchanan

doi:10.1302/1358-992X.94BSUPP_XXXIX.BOA2011-024

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General Orthopaedics

Review of patients at or under the age of fifty having total hip replacement using hydroxyapatite ceramic coated hip implants: a clinical and radiological evaluation with up to nineteen year follow-up

British Orthopaedic Association/Irish Orthopaedic Association Annual Congress (BOA/IOA)

J Buchanan

Review of patients at or under the age of fifty having total hip replacement using hydroxyapatite ceramic coated hip implants: a clinical and radiological evaluation with up to nineteen year follow-up

Buchanan J. Review of patients at or under the age of fifty having total hip replacement using hydroxyapatite ceramic coated hip implants: a clinical and radiological evaluation with up to nineteen year follow-up. Orthop Procs. 2012;94-B(SUPP_XXXIX):24-24. doi:10.1302/1358-992X.94BSUPP_XXXIX.BOA2011-024

Buchanan, J. “Review of patients at or under the age of fifty having total hip replacement using hydroxyapatite ceramic coated hip implants: a clinical and radiological evaluation with up to nineteen year follow-up.” Orthopaedic Proceedings, vol. 94-B, no. SUPP_XXXIX, 2012, pp. 24-24., https://doi.org/10.1302/1358-992X.94BSUPP_XXXIX.BOA2011-024

Buchanan, J. (2012). Review of patients at or under the age of fifty having total hip replacement using hydroxyapatite ceramic coated hip implants: a clinical and radiological evaluation with up to nineteen year follow-up. Orthopaedic Proceedings, 94-B(SUPP_XXXIX), 24-24. https://doi.org/10.1302/1358-992X.94BSUPP_XXXIX.BOA2011-024

Buchanan, J. (2012) “Review of patients at or under the age of fifty having total hip replacement using hydroxyapatite ceramic coated hip implants: a clinical and radiological evaluation with up to nineteen year follow-up.” Orthopaedic Proceedings, 94-B(SUPP_XXXIX), pp. 24-24. Available at: https://doi.org/10.1302/1358-992X.94BSUPP_XXXIX.BOA2011-024

Buchanan, J. “Review of patients at or under the age of fifty having total hip replacement using hydroxyapatite ceramic coated hip implants: a clinical and radiological evaluation with up to nineteen year follow-up.” Orthopaedic Proceedings 94-B, no. SUPP_XXXIX (2012): 24-24. https://doi.org/10.1302/1358-992X.94BSUPP_XXXIX.BOA2011-024

Buchanan J. Review of patients at or under the age of fifty having total hip replacement using hydroxyapatite ceramic coated hip implants: a clinical and radiological evaluation with up to nineteen year follow-up. Orthop Procs. 2012 Sep 1;94-B(SUPP_XXXIX):24-24. https://doi.org/10.1302/1358-992X.94BSUPP_XXXIX.BOA2011-024

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Abstract

Aims

Will Hydroxyapatite ceramic coated (HAC) arthroplasty perform well in patients under the age of fifty?

Methods

This is a study of 269 Hydroxyapatite ceramic coated (HAC) hip arthroplasties in patients under, the age of fifty with annual review using Harris Hip Score (HHS) and plain X-rays.

Assessments were over a maximum of 19 years.

Early patients (46) had implants with ceramic/plastic bearings. Later patients (223) all had ceramic on ceramic bearings.

Results

HHS showed 90.3% scoring over 90 or 100. Lower scores mostly relate to other joint and medical problems.

Aseptic loosening and thigh pain has not been a problem. Osteolysis and debris disease have only been seen rarely in hips with ceramic on polythene bearings.

Fractured alumina components have been encountered (6 heads and 3 acetabular liners, 2.1%). Ceramic/ceramic hips have otherwise remained successful.

Wear in polythene liners developed in 21 patients followed up more than 15 years (45.7%). 3 have been revised. The others are currently asymptomatic.

Other complications include one post operative death and 14 dislocations (5.2%).

Conclusions

HAC hip arthroplasty in patients under the age of fifty does well. Hydroxyapatite bonding provides lasting implant/bone stability. No patients have thigh pain. Considering bearing surfaces, polythene will wear out and contribute to osteolysis and debris disease. Alumina bearings occasionally fracture. Zirconia Toughened Alumina has superseded Alumina which should reduce or eliminate the incidence of ceramic failure.

HAC hip arthroplasty with ceramic bearings is advocated for patients under the age of fifty.