Abstract
Introduction:
Ceramic head with titanium-alloy sleeve offers a modular ceramic head solution for the damaged taper in revision total hip arthroplasty (THA). It can also be used in primary THA to reduce the risk of ceramic head fracture. The purpose of the present study was to report the intermediate-term outcomes of primary ceramic-on-ceramic THA with use of ceramic head with titanium-alloy sleeve.
Materials & Methods:
We evaluated 244 patients (271 hips) who had undergone primary ceramic-on-ceramic THA with use of BIOLOX® forte 32 mm ceramic head with titanium-alloy sleeve between November 2005 and August 2009. There were 158 males (175 hips) and 86 female (96 hips) patients with a mean age of 55.5 years. Clinical and radiographic evaluation was performed at a mean of 4.6 years (range, 2–7 years) postoperatively.
Results:
Mean Harris hip score improved from 46 points (range, 7–77 points) preoperatively to 91 points (range, 45–100 points) postoperatively. One (0.4%) ceramic heads fractured at 6 years postoperatively, which was treated with isolated cup revision and ceramic head exchange. Periprosthetic osteolysis was detected in 3 hips (1.1%), but not symptomatic in all patients. One patient (0.4%) complained of clicking in his operated hip. There was no aseptic loosening of the acetabular cup. Two (0.7%) out of 271 hips sustained aseptic loosening of the femoral stem (both were 14×9 mm small stem). Other complications included 3 (1.1%) deep infections, 2 (0.7%) dislocations, and 1 (0.4%) periprosthetic femoral fracture.
Conclusions:
The intermediate-term outcomes of primary ceramic-on-ceramic THA with use of BIOLOX® forte 32 mm head with titanium-alloy sleeve was encouraging. However, it is concerning that ceramic head fractures still occur, even in a very low incidence rate (0.4%). Additionally, long-term observation is required for periprosthetic osteolysis whether it comes from corrosion/fretting between taper and sleeve.
