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Ceramic bearings with bilayer coating in cementless total hip arthroplasty. A safe solution. A retrospective study of one hundred and twenty six cases with more than ten years’ follow-up

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Abstract

Purpose

Using a ceramic-ceramic bearings, cementless total hip arthroplasty (THA) has provided good clinical results. To ensure longevity a good quality fixation of the implants is mandatory. Different surface treatments had been used, with inconsistent results. We hypothesized that a “bilayer coating” applied to both THA components using validated technology will provide a long-lasting and reliable bone fixation.

Methods

We studied the survival and bone integration of a continuous, single-surgeon, retrospective series of 126 THA cases (116 patients) with an average follow-up of 12.2 years (minimum 10 years). The THA consisted of cementless implants with a bilayer coating of titanium and hydroxyapatite and used a ceramic–ceramic bearing.

Results

With surgical revision for any cause (except infection) as the end point, THA survival was 95.1 % at 13 years. Stem (98.8 %) and cup (98.6 %) survival was similar at 13 years. Bone integration was confirmed in 100 % of implants (Engh-Massin score of 17.42 and ARA score of 5.94). There were no instances of loosening. Revisions were performed because of instability (1.6 %), prosthetic impingement or material-related issues.

Conclusion

A bilayer titanium and hydroxyapatite coating provides strong, fast, reliable osseo integration, without deterioration at the interface or release of damaging particles. The good clinical outcomes expected of ceramic bearings were achieved, as were equally reliable stem and cup fixation.

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Authors and Affiliations

  1. Clinique du Parc-Lyon, 155 ter boulevard de Stalingrad, 69006, Lyon, France

    André Ferreira

  2. Groupe Lépine, Genay, France

    Thierry Aslanian

  3. Anatomy Laboratory, Université Claude Bernard Lyon 1, Lyon, France

    Thibaud Dalin

  4. Clinique Saint-Jean, Cagnes sur Mer, France

    Jean Picaud

Authors
  1. André Ferreira
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  2. Thierry Aslanian
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  3. Thibaud Dalin
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  4. Jean Picaud
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Corresponding author

Correspondence to André Ferreira.

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Conflict of interest

André Ferreira is consultant and receives royalties from Groupe Lépine

Thierry Aslanian is an employed of groupe Lépine

Thibaud Dalin has no conflict of interest with this work

Jean Picaud is consultant and receives royalties from Groupe Lépine

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Ferreira, A., Aslanian, T., Dalin, T. et al. Ceramic bearings with bilayer coating in cementless total hip arthroplasty. A safe solution. A retrospective study of one hundred and twenty six cases with more than ten years’ follow-up. International Orthopaedics (SICOT) 41, 893–899 (2017). https://doi.org/10.1007/s00264-016-3271-7

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  • DOI: https://doi.org/10.1007/s00264-016-3271-7

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