Skip to main content
SpringerLink
Log in

Effect of alumina femoral head on clinical results in cemented total hip arthroplasty: old versus current alumina

  • Original article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

The wear rate of polyethylene against alumina was demonstrated to be lower than against metal, and the results of early clinical studies of alumina-on-polyethylene combination were as good as expected, but the long-term results of alumina ceramic heads were not as good, as reported by several authors. The purpose of this study was to assess the clinical results over 10 years of cemented total hip arthroplasty (THA) with two types of alumina head: old and current alumina.

Methods

We compared the clinical results of these two types of alumina used for cemented THA. The first type was old alumina (containing 7% yttria), and 77 hips with a 28-mm head (group I) were included. The second type was current alumina (highly purified alumina), and 50 hips with a 26-mm head (group II) and 88 hips with a 22-mm head (group III) were included. The mean follow-up was 17 years 4 months in group I, 12 years 3 months in group II, and 10 years in group III.

Results

The Kaplan-Meier survival analysis, with revision for any reason as the endpoint, predicted 10-year survival rates of 90.8%, 100%, and 97.5% for groups I, II, and III, respectively. The survival curves differed significantly only between groups I and II. The probabilities of 10-year survival of the pros-theses with radiological loosening as the endpoint were 77.2%, 91.6%, and 96.5%, respectively. The survival curves showed significant differences only between groups II and III.

Conclusions

The old alumina showed a higher wear rate and rougher surface on the femoral head than did the current alumina in our previous study. The clinical results also indicated superiority of current alumina over old alumina. The difference in the size of the femoral head (26 vs. 22 mm) did not affect the clinical results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. TT Glant JJ Jacobs G Molnar AS Shanbhag M Valyon JO Galante (1993) ArticleTitleBone resorption activity of particulate-stimulated macrophages J Bone Miner Res 8 1071–9 Occurrence Handle1:CAS:528:DyaK2cXksValtbk%3D Occurrence Handle8237476 Occurrence Handle10.1002/jbmr.5650080907

    Article  CAS  PubMed  Google Scholar 

  2. WH Harris (1995) ArticleTitleThe problem of osteolysis Clin Orthop 311 46–53 Occurrence Handle7634590

    PubMed  Google Scholar 

  3. B Zicat CA Engh E Gokcen (1995) ArticleTitlePattern of osteolysis around total hip components inserted with and without cement J Bone Joint Surg Am 77 432–9 Occurrence Handle1:STN:280:DyaK2M7pslKqtA%3D%3D Occurrence Handle7890792

    CAS  PubMed  Google Scholar 

  4. JA Urban KL Garvin CK Boese L Bryson DR Pedersen JJ Callaghan et al. (2001) ArticleTitleCeramic-on-polyethylene bearing surfaces in total hip arthroplasty: seventeen to twenty-one-year results J Bone Joint Surg Am 83 1688–94 Occurrence Handle11701792

    PubMed  Google Scholar 

  5. IC Clarke A Gustafson H Jung A Fujisawa (1996) ArticleTitleHip-simulator ranking of polyethylene wear: comparisons between ceramic heads of different sizes Acta Orthop Scand 67 128–32 Occurrence Handle1:STN:280:DyaK283gtlKmsw%3D%3D Occurrence Handle8623565

    CAS  PubMed  Google Scholar 

  6. P Kumar M Oka K Ikeuchi K Shimizu T Yamamuro H Okumura et al. (1991) ArticleTitleLow wear rate of UHMWPE against zirconia ceramic (Y-PSZ) in comparison to alumina ceramic and SUS 316L alloy J Biomed Mater Res 25 813–28 10.1002/jbm.820250703 Occurrence Handle10.1002/jbm.820250703 Occurrence Handle1:STN:280:DyaK38%2FhtFyjug%3D%3D Occurrence Handle1918102

    Article  CAS  PubMed  Google Scholar 

  7. VO Saikko PO Paavolainen P Slätis (1993) ArticleTitleWear of the polyethylene acetabular cup: metallic and ceramic heads compared in a hip simulator Acta Orthop Scand 64 391–402 Occurrence Handle1:STN:280:DyaK2c%2Fis1agtA%3D%3D Occurrence Handle8213114

    CAS  PubMed  Google Scholar 

  8. M Semlitsch M Lehmann H Weber E Doerre HG Willert (1977) ArticleTitleNew prospects for a prolonged functional life-span of artificial hip joints by using the material combination polyethylene/aluminium oxide ceramic/metal J Biomed Mater Res 11 537–52 10.1002/jbm.820110409 Occurrence Handle10.1002/jbm.820110409 Occurrence Handle1:CAS:528:DyaE2sXltVKks7w%3D Occurrence Handle559675

    Article  CAS  PubMed  Google Scholar 

  9. A Wang A Essner (2001) ArticleTitleThree-body wear of UHMWPE acetabular cups by PMMA particles against CoCr, alumina and zirconia heads in a hip joint simulator Wear 250 212–6 10.1016/S0043-1648(01)00643-3 Occurrence Handle10.1016/S0043-1648(01)00643-3

    Article  Google Scholar 

  10. M Saito S Saito K Ohzono K Takaoka K Ono (1992) ArticleTitleEfficacy of alumina ceramic heads for cemented total hip arthroplasty Clin Orthop 283 171–7 Occurrence Handle1395242

    PubMed  Google Scholar 

  11. HM Schüller RK Marti (1990) ArticleTitleTen-year socket wear in 66 hip arthroplasties: ceramic versus metal heads Acta Orthop Scand 61 240–3 Occurrence Handle2371818

    PubMed  Google Scholar 

  12. LP Zichner HG Willert (1992) ArticleTitleComparison of alumina-polyethylene and metal-polyethylene in clinical trials Clin Orthop 282 86–94 Occurrence Handle1516333

    PubMed  Google Scholar 

  13. K Haraguchi N Sugano T Nishii T Sakai H Yoshikawa K Ohzono (2001) ArticleTitleAnalysis of survivorship after total hip arthroplasty using a ceramic head Clin Orthop 391 198–209 Occurrence Handle10.1097/00003086-200110000-00022 Occurrence Handle11603670

    Article  PubMed  Google Scholar 

  14. M Hasegawa T Ohashi T Tani (2001) ArticleTitlePoor outcome of 44 cemented total hip arthroplasties with alumina ceramic heads: clinical evaluation and retrieval analysis after 10–16 years Acta Orthop Scand 72 449–56 10.1080/000164701753532763 Occurrence Handle1:STN:280:DC%2BD3Mnot1SktQ%3D%3D Occurrence Handle11728070 Occurrence Handle10.1080/000164701753532763

    Article  CAS  PubMed  Google Scholar 

  15. CJ Sychterz CA Engh SuffixJr N Shah CA Engh SuffixSr (1997) ArticleTitleRadiographic evaluation of penetration by the femoral head into the polyethylene liner over time J Bone Joint Surg Am 79 1040–6 Occurrence Handle1:STN:280:DyaK2sznvVWquw%3D%3D Occurrence Handle9234880

    CAS  PubMed  Google Scholar 

  16. G Willmann (2000) ArticleTitleCeramic femoral head retrieval data Clin Orthop 379 22–8 Occurrence Handle10.1097/00003086-200010000-00004 Occurrence Handle11039788

    Article  PubMed  Google Scholar 

  17. K Tanaka J Tamura K Kawanabe M Shimizu T Nakamura (2003) ArticleTitleEffect of alumina femoral heads on polyethylene wear in cemented total hip arthroplasty: old versus current alumina J Bone Joint Surg Br 85 655–60 Occurrence Handle1:STN:280:DC%2BD3szlvFansg%3D%3D Occurrence Handle12892185

    CAS  PubMed  Google Scholar 

  18. GL Wolfgang (1990) ArticleTitleFemoral head autografting with total hip arthroplasty for lateral acetabular dysplasia: a 12-year experience Clin Orthop 255 173–85 Occurrence Handle2347151

    PubMed  Google Scholar 

  19. JG DeLee J Charnley (1976) ArticleTitleRadiological demarcation of cemented sockets in total hip replacement Clin Orthop 121 20–32 Occurrence Handle991504

    PubMed  Google Scholar 

  20. JP Hodgkinson P Shelley BM Wroblewski (1988) ArticleTitleThe correlation between the roentogenographic appearance and operative findings at the bone-cement junction of the socket in Charnley low friction arthroplasties Clin Orthop 228 105–9 Occurrence Handle3342551

    PubMed  Google Scholar 

  21. TA Gruen GM McNeice HC Amstutz (1979) ArticleTitle“Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening Clin Orthop 141 17–27 Occurrence Handle477100

    PubMed  Google Scholar 

  22. WH Harris JC McCarthy SuffixJr DA O’Neill (1982) ArticleTitleFemoral component loosening using contemporary techniques of femoral cement fixation J Bone Joint Surg Am 64 1063–7 Occurrence Handle1:STN:280:DyaL3s%2FgsleqsA%3D%3D Occurrence Handle7118973

    CAS  PubMed  Google Scholar 

  23. B Zicat CA Engh E Gokcen (1995) ArticleTitlePatterns of osteolysis around total hip components inserted with and without cement J Bone Joint Surg Am 77 432–9 Occurrence Handle1:STN:280:DyaK2M7pslKqtA%3D%3D Occurrence Handle7890792

    CAS  PubMed  Google Scholar 

  24. Shima Y, Tamaki T, Yokozaki M, Tanaka S, Yosinaga E, Tagawa H, et al. Theme 1: osteoarthritis Nippon Seikeigekagakkai Zasshi 1971;45:813-3

    Google Scholar 

  25. S Affatato B Bordini C Fagnano P Taddei A Tinti A Toni (2002) ArticleTitleEffects of the sterilisation method on the wear of UHMWPE acetabular cups tested in a hip joint simulator Biomaterials 23 1439–46 10.1016/S0142-9612(01)00265-4 Occurrence Handle10.1016/S0142-9612(01)00265-4 Occurrence Handle1:CAS:528:DC%2BD38XitV2hsw%3D%3D Occurrence Handle11829439

    Article  CAS  PubMed  Google Scholar 

  26. HA McKellop FW Shen P Campbell T Ota (1999) ArticleTitleEffect of molecular weight, calcium stearate, and sterilization methods on the wear of ultra high molecular weight polyethylene acetabular cups in a hip joint simulator J Orthop Res 17 329–39 10.1002/jor.1100170306 Occurrence Handle10.1002/jor.1100170306 Occurrence Handle1:STN:280:DyaK1MzgtlaisQ%3D%3D Occurrence Handle10376720

    Article  CAS  PubMed  Google Scholar 

  27. SM Madey JJ Callaghan JP Olejniczak DD Goetz RC Johnston (1997) ArticleTitleCharnley total hip arthroplasty with use of improved technique of cementing: the results after a minimum of fifteen years of follow-up J Bone Joint Surg Am 79 53–64 10.1302/0301-620X.79B1.6699 Occurrence Handle10.1302/0301-620X.79B1.6699 Occurrence Handle1:STN:280:DyaK2s7mtleltA%3D%3D Occurrence Handle9010186

    Article  CAS  PubMed  Google Scholar 

  28. WF Mulroy DM Estok WH Harris (1995) ArticleTitleTotal hip arthroplasty with use of so-called second-generation cementing techniques: a fifteen-year-average follow-up study J Bone Joint Surg Am 77 1845–52 Occurrence Handle1:STN:280:DyaK287gvFSqug%3D%3D Occurrence Handle8550652

    CAS  PubMed  Google Scholar 

  29. JJ Callaghan DR Pedersen JP Olejniczak DD Goetz RC Johnston (1995) ArticleTitleRadiographic measurement of wear in 5 cohorts of patients observed for 5 to 22 years Clin Orthop 317 14–8 Occurrence Handle7671468

    PubMed  Google Scholar 

  30. S Eggli S z’Brun C Gerber R Ganz (2002) ArticleTitleComparison of polyethylene wear with femoral heads of 22 mm and 32 mm: a prospective, randomised study J Bone Joint Surg Br 84 447–51 10.1302/0301-620X.84B3.11344 Occurrence Handle10.1302/0301-620X.84B3.11344 Occurrence Handle1:STN:280:DC%2BD383mt1yqug%3D%3D Occurrence Handle12002509

    Article  CAS  PubMed  Google Scholar 

  31. U Kesteris T Ilchmann H Wingstrand R Onnerfalt (1996) ArticleTitlePolyethylene wear in Scanhip arthroplasty with a 22 or 32 mm head: 62 matched patients followed for 7–9 years Acta Orthop Scand 67 125–7 Occurrence Handle1:STN:280:DyaK283gtlKmsg%3D%3D Occurrence Handle8623564

    CAS  PubMed  Google Scholar 

  32. S Kobayashi NS Eftekhar K Terayama R Iorio (1994) ArticleTitleRisk factors affecting radiological failure of the socket in primary Charnley low friction arthroplasty: a 10- to 20-year followup study Clin Orthop 306 84–96 Occurrence Handle8070215

    PubMed  Google Scholar 

  33. J Livermore D Ilstrup B Morrey (1990) ArticleTitleEffect of femoral head size on wear of the polyethylene acetabular component J Bone Joint Surg Am 72 518–28 Occurrence Handle1:STN:280:DyaK3c3hs1OksQ%3D%3D Occurrence Handle2324138

    CAS  PubMed  Google Scholar 

  34. BM Wroblewski PA Fleming PD Siney (1999) ArticleTitleCharnley low-frictional torque arthroplasty of the hip: 20- to 30-year results J Bone Joint Surg Br 81 427–30 10.1302/0301-620X.81B3.9521 Occurrence Handle10.1302/0301-620X.81B3.9521 Occurrence Handle1:STN:280:DC%2BD3czjtFWlsQ%3D%3D Occurrence Handle10872359

    Article  CAS  PubMed  Google Scholar 

  35. F Higuchi N Shiba A Inoue I Wakebe (1995) ArticleTitleFracture of an alumina ceramic head in total hip arthroplasty J Arthroplasty 10 851–4 10.1016/S0883-5403(05)80086-5 Occurrence Handle10.1016/S0883-5403(05)80086-5 Occurrence Handle1:STN:280:DyaK28zls1Cqtg%3D%3D Occurrence Handle8749772

    Article  CAS  PubMed  Google Scholar 

  36. EW Fritsch M Gleitz (1996) ArticleTitleCeramic femoral head fractures in total hip arthroplasty Clin Orthop 328 129–36 10.1097/00003086-199607000-00021 Occurrence Handle10.1097/00003086-199607000-00021 Occurrence Handle8653945

    Article  PubMed  Google Scholar 

  37. TP Schmalzried EF Shepherd FJ Dorey WO Jackson M dela Rosa F Fa’vae et al. (2000) ArticleTitleWear is a function of use, not time Clin Orthop 381 36–46 Occurrence Handle10.1097/00003086-200012000-00005 Occurrence Handle11127668

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Keiichi Kawanabe, Kenji Tanaka, Jiro Tamura, Motoyuki Shimizu, Eijiro Onishi & Takashi Nakamura

  2. Department of Orthopaedic Surgery, Kansai Medical University, Osaka, Japan

    Hirokazu Iida

Authors
  1. Keiichi Kawanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kenji Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jiro Tamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Motoyuki Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eijiro Onishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hirokazu Iida
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takashi Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Kawanabe, K., Tanaka, K., Tamura, J. et al. Effect of alumina femoral head on clinical results in cemented total hip arthroplasty: old versus current alumina. J Orthop Sci 10, 378–384 (2005). https://doi.org/10.1007/s00776-005-0911-y

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00776-005-0911-y

Keywords

Search

Navigation