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Randomized Controlled Trial
. 2013 Nov;37(11):2131-7.
doi: 10.1007/s00264-013-2036-9. Epub 2013 Aug 3.

A randomised prospective evaluation of ceramic-on-ceramic and ceramic-on-highly cross-linked polyethylene bearings in the same patients with primary cementless total hip arthroplasty

Young-Hoo Kim  1 , Jang-Won Park, Sourabh S Kulkarni, Yoon-Hong Kim
Affiliations
Randomized Controlled Trial

A randomised prospective evaluation of ceramic-on-ceramic and ceramic-on-highly cross-linked polyethylene bearings in the same patients with primary cementless total hip arthroplasty

Young-Hoo Kim et al. Int Orthop. 2013 Nov.

Abstract

Purpose: Very few studies have compared alumina-on-alumina ceramic and alumina-on-highly cross-linked polyethylene bearings in the same patient. The purpose of this prospective randomised study was to compare the clinical and radiographic results and the prevalence of osteolysis in cementless total hip arthroplasty using an alumina-on-alumina and alumina-on-highly cross-linked polyethylene bearings in young active patients.

Methods: We prospectively compared the results of 100 patients (200 hips) who had undergone a cementless total hip arthroplasty with an alumina-on-alumina ceramic bearing in one hip and an alumina-on-highly cross-linked polyethylene in the other. There were 66 men and 34 women with a mean age of 45.3 years (range, 21-49 years) at the time of surgery. The mean follow-up was 12.4 years (range, 11-13 years). The patients were assessed clinically and radiographically at three months, one year, and annually thereafter.

Results: Harris hip, Western Ontario and McMaster Universities Osteoarthritis Index, and University of California, Los Angeles activity scores did not show statistically significant differences between the two groups of bearings preoperatively or at the time of final follow-up. Radiographic findings of the component were not significantly different between the two groups. The mean polyethylene linear penetration was 0.031 ± 0.004 mm per year. No hips in either group displayed osteolysis. The Kaplan-Meier survivorship with revision as the end point at 12.4 years was 100% (95% confidence interval [CI], 94-100%) for the femoral component in both groups and 99% (95%CI, 93-100%) for the acetabular component.

Conclusion: The clinical and radiographic results of using an alumina-on-alumina ceramic and alumina-on-highly cross-linked polyethylene bearings were similar.

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Figures

Fig. 1
Fig. 1
Radiographs of a 43-year-old woman with osteonecrosis of both femoral heads. a A preoperative anteroposterior view of both hips shows a collapsed femoral head and Dorr type-A femoral bone. b An anteroposterior view of both hips taken 12 years after the hip arthroplasty shows that the acetabular and femoral components at both hips are solidly fixed in a satisfactory position, with no evidence of osteolysis. The right hip has an alumina-on-alumina ceramic bearing and the left hip has an alumina-on-highly cross-linked polyethylene
See this image and copyright information in PMC

References

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