Third-Generation Alumina-on-Alumina Total Hip Arthroplasty: 14 to 16-Year Follow-Up Study
Section snippets
Materials and Methods
Between February 1998 and February 2000, 108 primary THAs were performed at the author’s hospital. Among them 104 THAs (89 patients) were performed using a single cementless prosthesis design with alumina-on-alumina articulation. In the remaining 4 patients (4 hips) with small femoral dimensions, that prosthesis could not be used. These 4 patients underwent THA with other prosthesis and were excluded from the study.
Five patients (5 hips) were not followed for a minimum of 14 years. Eight
Results
The three femoral fractures, which occurred during insertion of the stem, healed completely, and osseointegration of the prosthesis was achieved. Two hips dislocated after a stumble at postoperative 5 days and 3 weeks, respectively. They were treated successfully with closed reduction and abduction bracing for 3 months, after which, there was no recurrence.
One patient sustained a periprosthetic fracture after falling from a height of 3 m at 9 years postoperatively. The fracture occurred just distal
Discussion
This is the first report on the 15-year follow-up results of THA with the use of a contemporary alumina-on-alumina articulation. We limited our subjects to patients who were followed for 14 to 16 years. In the current follow-up, there was no detectable wear, osteolysis or prosthetic loosening and the survival rate was 98.9%.
The COC articulation has been used for THA during more than 40 years. Since 1990, mechanical properties of alumina have been substantially improved. The third generation
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2021, Ceramics InternationalCitation Excerpt :With an increasing number of younger patients undergoing THA along with expected increases in longevity of the population, there is a need to guarantee bearings survivorship beyond the second decade of service [13]. Ceramic bearings have been used in THA for over 3 decades thanks to some positive characteristics, including low wear, wettability, and low bioreactivity [14–17]. As of today, however, some concerns with component fractures and reliability still remain [18].
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2021, Orthopaedics and Traumatology: Surgery and ResearchCitation Excerpt :In our CoC group of second-generation bearings, no fracture was observed. Similarly, Kang et al. reported no fracture of the ceramic bearing in 90 hips of third-generation alumina–on–alumina THA at 15 years [23]. In contrast, in a multicentre prospective study by Migaud et al., 16% (37/238) of CoC hips had ceramic-specific reasons for revision (ceramic breakage, squeaking, impingement, and incorrect ceramic insertion) [20].
Level of evidence: therapeutic study, level IV.
The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2014.09.020.