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Preventing ceramic liner fracture after Delta ceramic-on-ceramic total hip arthroplasty

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

The results of total hip arthroplasty (THA) with use of Delta ceramic articulation were successful at medium term follow-up. The use of this newest ceramic has markedly reduced the incidence of ceramic head fractures, but not the incidence of ceramic liner fractures. We tested a hypothesis that the ceramic fractures are prevented by use of a metal shell with 18° inner taper angle and a stem design with a reduced neck geometry.

Methods

We conducted a prospective multicenter study of cementless THA with use of 32/36-mm Delta ceramic bearing, Exceed ABT metal shell and Taperloc stem. We evaluated ceramic fracture, noise, clinical results, radiological changes and survival rate at a minimum of 5-year follow-up.

Results

From April 2010 to February 2012, 246 patients (274 THAs) were enrolled. Among them, 224 patients (130 men and 94 women, 250 hips) were followed-up for 5–8 years (mean 6.0 years). Ceramic malseating or fracture did not occur in any patient. Eight patients (8 hips, 3.2%) reported noise. Mean Harris hip score was 84 points at the latest follow-up. All acetabular and femoral components had bone-ingrown stability. Two hips were revised due to recurrent dislocation and periprosthetic fracture. The survival rate was 99.6% at 8 years postoperatively.

Conclusion

Ceramic fractures can be prevented by a use of (1) 32/36-mm Delta ceramic bearing, (2) metal shell with 18° taper angle, and (2) stem with a reduced neck geometry. However, noise remains a concern of the Delta ceramic bearing.

Level of evidence

Therapeutic level II.

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Funding

This study was supported by Zimmer Biomet Korea.

Author information

Author notes

  1. Young-Kyun Lee and Jae-Young Lim contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea

    Young-Kyun Lee & Kyung-Hoi Koo

  2. Department of Orthopaedic Surgery, Inje University Haeundae Paik Hospital, Busan, South Korea

    Jae-Young Lim

  3. Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, South Korea

    Yong-Chan Ha

  4. Department of Orthopaedic Surgery, Konkuk University Hospital, Seoul, South Korea

    Tae-Young Kim

  5. Department of Orthopaedic Surgery, Murup Hospital, Masan, South Korea

    Woon-Hwa Jung

  6. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea

    Kyung-Hoi Koo

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  1. Young-Kyun Lee
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Correspondence to Yong-Chan Ha.

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The corresponding author has received funding from Zimmer Biomet Korea.

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Lee, YK., Lim, JY., Ha, YC. et al. Preventing ceramic liner fracture after Delta ceramic-on-ceramic total hip arthroplasty. Arch Orthop Trauma Surg 141, 1155–1162 (2021). https://doi.org/10.1007/s00402-020-03515-2

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  • DOI: https://doi.org/10.1007/s00402-020-03515-2

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