High survivorship with a titanium-encased alumina ceramic bearing for total hip arthroplasty

James A. D'Antonio, William Capello, Marybeth Naughton

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Although ceramic-on-ceramic bearings for total hip arthroplasty (THA) show promising results in terms of bearing-surface wear, fracture of the bearing, insertional chips, and squeaking remain a concern. Questions/purposes: Our primary objective of this report was to determine overall survivorship of a titanium-encased ceramic-on-ceramic bearing couple. Our secondary objectives were to evaluate for ceramic fracture, insertional chips, osteolysis, and device squeaking. Methods: Six surgeons at six institutions implanted 194 patients (209 hips) with an average age of 52 years with cementless hips and alumina ceramic bearings. One hundred thirty-seven patients (146 hips) have 10-year followup (70%). We determined Kaplan-Meier survivorship of the bearing surface and implant system and collected radiographic and clinical data to evaluate for osteolysis and squeaking. Results: Survivorship using revision for any reason as the end point was 97% at 10 years and survivorship end point bearing surface failure or aseptic loosening of 99%. There was one ceramic insert fracture (0.5%), there were no insertional chips, there was no visible osteolysis on AP and lateral radiographs, and there was a 1% patient-self-reported incidence of squeaking at the last clinical followup. Six hips underwent revision (3.7%). Conclusions: Ceramic bearings for THA with a titanium-encased insert have high survivorship at 10 years followup and a fracture risk of 0.5%. We found at last followup on routine radiographs no evidence of osteolysis, and no patient has been revised for squeaking or has reported dissatisfaction with the clinical result because of noise. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Original languageEnglish
Pages (from-to)611-616
Number of pages6
JournalClinical Orthopaedics and Related Research
Volume472
Issue number2
DOIs
StatePublished - Feb 2014

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Aluminum Oxide
Ceramics
Titanium
Arthroplasty
Hip
Survival Rate
Osteolysis
Noise
Guidelines
Equipment and Supplies
Incidence

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

High survivorship with a titanium-encased alumina ceramic bearing for total hip arthroplasty. / D'Antonio, James A.; Capello, William; Naughton, Marybeth.

In: Clinical Orthopaedics and Related Research, Vol. 472, No. 2, 02.2014, p. 611-616.

Research output: Contribution to journalArticle

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abstract = "Background: Although ceramic-on-ceramic bearings for total hip arthroplasty (THA) show promising results in terms of bearing-surface wear, fracture of the bearing, insertional chips, and squeaking remain a concern. Questions/purposes: Our primary objective of this report was to determine overall survivorship of a titanium-encased ceramic-on-ceramic bearing couple. Our secondary objectives were to evaluate for ceramic fracture, insertional chips, osteolysis, and device squeaking. Methods: Six surgeons at six institutions implanted 194 patients (209 hips) with an average age of 52 years with cementless hips and alumina ceramic bearings. One hundred thirty-seven patients (146 hips) have 10-year followup (70{\%}). We determined Kaplan-Meier survivorship of the bearing surface and implant system and collected radiographic and clinical data to evaluate for osteolysis and squeaking. Results: Survivorship using revision for any reason as the end point was 97{\%} at 10 years and survivorship end point bearing surface failure or aseptic loosening of 99{\%}. There was one ceramic insert fracture (0.5{\%}), there were no insertional chips, there was no visible osteolysis on AP and lateral radiographs, and there was a 1{\%} patient-self-reported incidence of squeaking at the last clinical followup. Six hips underwent revision (3.7{\%}). Conclusions: Ceramic bearings for THA with a titanium-encased insert have high survivorship at 10 years followup and a fracture risk of 0.5{\%}. We found at last followup on routine radiographs no evidence of osteolysis, and no patient has been revised for squeaking or has reported dissatisfaction with the clinical result because of noise. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.",
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