Abstract
Introduction
The number of total hip arthroplasties in young patients is continuosly increasing. Nowdays, the study of the materials wear, with the goal of improving the survivorship of implants, represents a fundamental subject in this kind of surgery. The role of ceramic materials in the valutation of types of wear is particularly known.
Materials and Methods
We have selected 834 patients, underwent total hip arthroplasty, in which a ceramic head was impalnted with a maximum follow up of ten years. 367 patients were males and 467 were females, operated by 14 surgeons of the same equipe of Orthopaedic and Traumatology Department. A postero-lateral approach, according to Gibson Moore, and an extrarotator tendons transosseal repair was performed.
Results
446 ceramic liners, 354 polyethylene liners and 34 metallic liners were used. 18 types of stems, 5 of which stemless, were implanted. The mean survivorship of all cohrt of patients was 92% at 10 years. No ceramic heads and liners breakage occurred. In particular, of 69 total hip arthroplasties, implanted in 2005, only 3 were revised.
Discussion
In our cohort review no major failures of ceramic components were observed. These datas suggested the importance of design and up grading of new materials, in order to achieve better long term results. Therefore, the ceramic components represent the gold standard, specifically in young active patients with good long term results reguarding functional outcomes and wear of implants.
Conclusions
The use of ceramic head, assembled with ceramic or polyethylene liners, also demonstrated good results at 10 years follow up. Ceramic-on- polyethylene is a valid alternative to ceramic-on-ceramic in consideration of the lower cost and theoretical lower risk of breakage.
