Hip Pelvis.  2015 Dec;27(4):223-231. 10.5371/hp.2015.27.4.223.

Cementless Revision Total Hip Arthroplasty with Ceramic Articulation

Affiliations
  • 1Department of Orthopedic Surgery, Inha University School of Medicine, Incheon, Korea. moon@inha.ac.kr

Abstract

PURPOSE
The results of ceramic-on-ceramic (CoC) bearing surfaces in primary total hip arthroplasty (THA) were well known. However, it was not known in revision THA. The purpose of this study is to report the results of revision THA with ceramic articulation.
MATERIALS AND METHODS
A total of 112 revision THAs were evaluated. The mean age at the time of surgery was 51.6 years (27.7 to 84.2 years). The mean duration of the follow-up periods was 6.3 years (2.3 to 11.4 years).
RESULTS
The Harris hip scores improved from an average of 56.2 at the index surgery to an average of 93.3 at the last follow-up (P<0.001). None of hips showed osteolysis or ceramic head fracture. One hip showed aseptic loosening in the acetabular component with squeaking that caused a re-revision. There were nine cases of dislocation. The survivorship at 5 years was 94.5% (95% confidence interval, 87.9% to 97.6%) with revision for any reason as the endpoint and 100% with femoral revision.
CONCLUSION
The ceramic articulation is one of good bearing options for revision THA in patients with a long life expectancy.

Keyword

Revision total hip arthroplasty; Ceramic articulation

MeSH Terms

Acetabulum
Arthroplasty, Replacement, Hip*
Ceramics*
Dislocations
Follow-Up Studies
Head
Hip
Humans
Life Expectancy
Osteolysis
Survival Rate
Ceramics

Figure

  • Fig. 1 Anteroposterior radiographs showing the hip implant with loosening due to collapse of the structural bone graft. The loosening occurred six years after the revision, and the cup showed 3 mm migration, and 16° change in tilting. An allo-femoral head structural bone graft was used to replace the extensive osteolytic lesion, which was type IIIB defect according to the Paprosky's classification of bone defects. One year postoperatively there had been no further complications. (A) Postoperative radiograph after the first revision arthroplasty. (B) Follow-up radiograph 72 months after first revision arthroplasty. (C) Postoperative radiograph after the re-revision.

  • Fig. 2 Anteroposterior radiographs showing the hip implant with dislocation. The dislocation occurred three years after the revision. One year postoperatively there had been no further complications. (A) Postoperative radiograph after the first revision arthroplasty. (B) Follow-up radiograph 36 months after first revision arthroplasty. (C) Postoperative radiograph after the re-revision.

  • Fig. 3 Kaplan-Meier survival with 95% confidence intervals, with revision for any reason as the endpoint. The survivorships of 5 years and 10 years were 94.5% and 92.9%, respectively.


Reference

1. Kurtz S, Mowat F, Ong K, Chan N, Lau E, Halpern M. Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am. 2005; 87:1487–1497.
Article
2. Ulrich SD, Seyler TM, Bennett D, et al. Total hip arthroplasties: what are the reasons for revision? Int Orthop. 2008; 32:597–604.
Article
3. Pospischill M, Knahr K. Cementless total hip arthroplasty using a threaded cup and a rectangular tapered stem. Follow-up for ten to 17 years. J Bone Joint Surg Br. 2005; 87:1210–1215.
4. Zichner L, Lindenfeld T. In-vivo wear of the slide combinations ceramics-polyethylene as opposed to metal-polyethylene. Orthopade. 1997; 26:129–134.
5. Amstutz HC, Campbell P, Kossovsky N, Clarke IC. Mechanism and clinical significance of wear debris-induced osteolysis. Clin Orthop Relat Res. 1992; (276):7–18.
Article
6. Brodner W, Bitzan P, Meisinger V, Kaider A, Gottsauner-Wolf F, Kotz R. Serum cobalt levels after metal-on-metal total hip arthroplasty. J Bone Joint Surg Am. 2003; 85-A:2168–2173.
Article
7. Hallab N, Merritt K, Jacobs JJ. Metal sensitivity in patients with orthopaedic implants. J Bone Joint Surg Am. 2001; 83-A:428–436.
Article
8. Jack CM, Molloy DO, Walter WL, Zicat BA, Walter WK. The use of ceramic-on-ceramic bearings in isolated revision of the acetabular component. Bone Joint J. 2013; 95-B:333–338.
Article
9. Pospischill M, Knahr K. Strategies for head and inlay exchange in revision hip arthroplasty. Int Orthop. 2011; 35:261–265.
Article
10. Paprosky WG, Burnett RS. Assessment and classification of bone stock deficiency in revision total hip arthroplasty. Am J Orthop (Belle Mead NJ). 2002; 31:459–464.
11. Williams VG 2nd, Whiteside LA, White SE, McCarthy DS. Fixation of ultrahigh-molecular-weight polyethylene liners to metal-backed acetabular cups. J Arthroplasty. 1997; 12:25–31.
Article
12. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969; 51:737–755.
Article
13. Jasty M, Harris WH. Salvage total hip reconstruction in patients with major acetabular bone deficiency using structural femoral head allografts. J Bone Joint Surg Br. 1990; 72:63–67.
Article
14. Cadambi A, Engh GA, Dwyer KA, Vinh TN. Osteolysis of the distal femur after total knee arthroplasty. J Arthroplasty. 1994; 9:579–594.
Article
15. revisan C, Nava V, Mattavelli M, Parra CG. Bisphosphonate treatment for osteolysis in total hip arthroplasty. A report of four cases. Clin Cases Miner Bone Metab. 2013; 10:61–64.
16. Tamaki Y, Goto T, Hamada D, et al. Massive femoral osteolysis secondary to loosening of a cemented roughened long stem: a case report. Case Rep Orthop. 2014; 2014:840267.
Article
17. DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res. 1976; (121):20–32.
Article
18. Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res. 1990; (257):107–128.
Article
19. Melloh M, Eggli S, Busato A, Roder C. Predictors of early stem loosening after total hip arthroplasty: a case-control study. J Orthop Surg (Hong Kong). 2011; 19:269–273.
Article
20. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978; 60:217–220.
Article
21. Woo RY, Morrey BF. Dislocations after total hip arthroplasty. J Bone Joint Surg Am. 1982; 64:1295–1306.
Article
22. Murphy SB, Simon SR, Kijewski PK, Wilkinson RH, Griscom NT. Femoral anteversion. J Bone Joint Surg Am. 1987; 69:1169–1176.
Article
23. Renkawitz T, Sendtner E, Schuster T, Weber M, Grifka J, Woerner M. Femoral pinless length and offset measurements during computer-assisted, minimally invasive total hip arthroplasty. J Arthroplasty. 2014; 29:1021–1025.
Article
24. Murray DW, Carr AJ, Bulstrode C. Survival analysis of joint replacements. J Bone Joint Surg Br. 1993; 75:697–704.
Article
25. Han CD, Choe WS, Yoo JH. Effect of polyethylene wear on osteolysis in cementless primary total hip arthroplasty: minimal 5-year follow-up study. J Arthroplasty. 1999; 14:714–723.
Article
26. Hooper GJ, Rothwell AG, Stringer M, Frampton C. Revision following cemented and uncemented primary total hip replacement: a seven-year analysis from the New Zealand Joint Registry. J Bone Joint Surg Br. 2009; 91:451–458.
27. Bierbaum BE, Nairus J, Kuesis D, Morrison JC, Ward D. Ceramic-on-ceramic bearings in total hip arthroplasty. Clin Orthop Relat Res. 2002; (405):158–163.
Article
28. Chang JD, Kamdar R, Yoo JH, Hur M, Lee SS. Third-generation ceramic-on-ceramic bearing surfaces in revision total hip arthroplasty. J Arthroplasty. 2009; 24:1231–1235.
Article
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