Large head ceramic-on-ceramic bearing in primary total hip arthroplasty: average 3-year follow-up of a multicentre study. Issue 6 (November 2020)

• Record Type: Journal Article
• Authors: Lavigne, Martin; Vendittoli, Pascal-André; Virolainen, Petri; Corten, Kristoff; Martinez, Mariano; Zicat, Bernard; Peter, Viju; Bloem, Rolf; Miazzolo, Nicolas; Remes, Ville
• Is Part Of: Hip international. Volume 30:Issue 6(2020)
• Page Start: 711
• Page End: 717
• Publication Date: 2020-11
• Subjects: Acetabular component -- ceramic-on-ceramic bearing -- monoblock cup -- outcome -- total hip arthroplasty; Hip joint -- Pathophysiology -- Periodicals; Hip joint -- Diseases -- Periodicals; Hip joint -- Surgery -- Periodicals; 617.581005
• DOI: 10.1177/1120700019863376
• Languages: English
• ISSNs: 1120-7000

Abstract

Background: Surgeons are increasingly using larger femoral head sizes in total hip arthroplasty (THA) to improve stability and reduce the rate of dislocation, 1 of the leading causes of revision surgery. Large ceramic head sizes up to 48 mm can now be used with monoblock acetabular components. National registries have shown promising results at short-term with large diameter ceramic-on-ceramic THA, with very low revision rates. This study reports on the average 3-year follow up of a press-fit monoblock large diameter acetabular shell with a pre-assembled ceramic liner, with emphasis on the radiographic outcome, complications related to the implantation of the cup, and the patient's clinical outcome. Methods: 170 hips in 169 patients were reviewed at an average 38 ± 5.8 months following surgery. Results: The radiographic review revealed no acetabular cup loosening, no osteolysis and no cup migration. 1 acetabular cup was revised for malposition. The patient clinical outcome and the satisfaction rate were excellent. At 3 years, 7.1% of patients complained of groin pain and 3.5% spontaneously reported hip joint generated noise. 1 patient sustained a non-recurrent traumatic hip dislocation 2 years post surgery. Conclusions: New technology should be introduced cautiously on the market. This is especially true for the large diameter ceramic monoblock acetabular component used in this study since it involves a new acetabular component design. At short term, we have not identified new modes of failure with this implant. Longer follow-up is still needed to assess the safety of large ceramic bearing in THA.