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A Mid-Term Analysis Suggests Ceramic on Ceramic Hip Arthroplasty Is Durable with Minimal Wear and Low Risk of Squeak

  • Current Topics Concerning Joint Preservation and Minimally Invasive Surgery of the Hip
  • Published:
HSS Journal ®

Abstract

Background

The incidence of hip replacements in the younger patient is ever increasing. With this in mind, improving the longevity of hip arthroplasties is paramount. Alumina ceramic is a promising bearing surface due to its low wear rate and biological inertness.

Purpose

This study aims to review our experience with ceramic-on-ceramic total hip arthroplasty, reporting on the need for revision as well as the cause of failure. Our secondary purpose is to review our experience with the phenomenon of squeaking analysing and its effect on clinical outcome with specific emphasis on component positioning. Also reported are the results of our retrieval analysis of explanted components documenting the wear rate and our analysis of strip wear.

Methods

A consecutive series of 301 primary cementless alumina-on-alumina total hip arthroplasties at a minimum of 10 years follow-up was reviewed. These arthroplasties all had third-generation ceramic-on-ceramic bearings performed through a posterior approach with repair of capsule and external rotators to bone. We analysed hips both clinically and radiographically. Analysis of wear in 62 ceramic bearings was performed using a Roundtest RA300 machine (Mitutoyo; Andover, UK), which has an accuracy of 0.01 μm.

Results

Overall, the survival rate of the implants was 98% at 10 years. No ceramic fractures were encountered in this study. Seventy-four patients reported squeaking hips, and two cases were revised due to squeaking (0.6%). No failures were related to bearing wear.

Conclusions

We believe that ceramic-on-ceramic is a safe bearing coupling with excellent survivorship at 10 years.

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Disclosures

One or more of the authors (DM, CJ and WKW) has received research funding from Depuy, Stryker. Dr. Walter is a member of a speakers' bureau or has made paid presentations on behalf of Stryker and Finsbury, serves as a paid consultant to or is an employee of Finsbury and has received research or institutional support from Stryker, DePuy Finsbury, CeramTec and global Orthopaedics. Dr. Molloy or an immediate family member has received research or institutional support from Stryker, DePuy. Dr. Jack or an immediate family member has received research or institutional support from Stryker, DePuy. C. Esposito or an immediate family member has received research or institutional support from Finsbury. Dr. Walter or an immediate family member has received royalties from Stryker and DePuy, is a member of a speakers' bureau or has made paid presentations on behalf of Stryker and Finsbury, serves as a paid consultant to or is an employee of Finsbury and has received research or institutional support from Stryker, DePuy Finsbury, CeramTec and global Orthopaedics.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Authors and Affiliations

  1. Sydney Hip and Knee Surgeons, North Sydney, New South Wales, Australia

    Dennis Molloy MB, FRCS (Tr&Orth), Mphil, Chris Jack MB, FRCS (Tr&Orth), BSc, Christina Esposito BSc & William L. Walter MBBS, FRACS, PhD

Authors
  1. Dennis Molloy MB, FRCS (Tr&Orth), Mphil
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  2. Chris Jack MB, FRCS (Tr&Orth), BSc
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  3. Christina Esposito BSc
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  4. William L. Walter MBBS, FRACS, PhD
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Corresponding author

Correspondence to Dennis Molloy MB, FRCS (Tr&Orth), Mphil.

Additional information

Level of Evidence: Level IV: Therapeutic Study. See Levels of Evidence for a complete description.

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Molloy, D., Jack, C., Esposito, C. et al. A Mid-Term Analysis Suggests Ceramic on Ceramic Hip Arthroplasty Is Durable with Minimal Wear and Low Risk of Squeak. HSS Jrnl 8, 291–294 (2012). https://doi.org/10.1007/s11420-012-9291-y

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  • DOI: https://doi.org/10.1007/s11420-012-9291-y

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