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      • Record: found
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      Cementless Revision Total Hip Arthroplasty with Ceramic Articulation

      research-article
      Author(s): , MD, , MD, , MD, , MD
      Publication date (Electronic):
      Journal: Hip & Pelvis
      Publisher: Korean Hip Society
      Keywords: Revision total hip arthroplasty, Ceramic articulation

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          Abstract

          Purpose

          The results of ceramic-on-ceramic (CoC) bearing surfaces in primary total hip arthroplasty (THA) were well known. However, it was not known in revision THA. The purpose of this study is to report the results of revision THA with ceramic articulation.

          Materials and Methods

          A total of 112 revision THAs were evaluated. The mean age at the time of surgery was 51.6 years (27.7 to 84.2 years). The mean duration of the follow-up periods was 6.3 years (2.3 to 11.4 years).

          Results

          The Harris hip scores improved from an average of 56.2 at the index surgery to an average of 93.3 at the last follow-up ( P<0.001). None of hips showed osteolysis or ceramic head fracture. One hip showed aseptic loosening in the acetabular component with squeaking that caused a re-revision. There were nine cases of dislocation. The survivorship at 5 years was 94.5% (95% confidence interval, 87.9% to 97.6%) with revision for any reason as the endpoint and 100% with femoral revision.

          Conclusion

          The ceramic articulation is one of good bearing options for revision THA in patients with a long life expectancy.

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          Most cited references25

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          Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002.

          Steven Kurtz, Fionna Mowat, Kevin Ong … (2005)
          The purpose of this study was to quantify the procedural rate and revision burden of total hip and knee arthroplasty in the United States and to determine if the age or gender-based procedural rates and overall revision burden are changing over time. The National Hospital Discharge Survey (NHDS) for 1990 through 2002 was used in conjunction with United States Census data to quantify the rates of primary and revision arthroplasty as a function of age and gender within the United States with use of methodology published by the American Academy of Orthopaedic Surgeons. Poisson regression analysis was used to evaluate the procedural rate and to determine year-to-year trends in primary and revision arthroplasty rates as a function of both age and gender. Both the number and the rate of total hip and knee arthroplasties (particularly knee arthroplasties) increased steadily between 1990 and 2002. Over the thirteen years, the rate of primary total hip arthroplasties per 100,000 persons increased by approximately 50%, whereas the corresponding rate of primary total knee arthroplasties almost tripled. The rate of revision total hip arthroplasties increased by 3.7 procedures per 100,000 persons per decade, and that of revision total knee arthroplasties, by 5.4 procedures per 100,000 persons per decade. However, the mean revision burden of 17.5% for total hip arthroplasty was more than twice that for total knee arthroplasty (8.2%), and this did not change substantially over time. The number and prevalence of primary hip and knee replacements increased substantially in the United States between 1990 and 2002, but the trend was considerably more pronounced for primary total knee arthroplasty. The reported prevalence trends have important ramifications with regard to the number of joint replacements expected to be performed by orthopaedic surgeons in the future. Because the revision burden has been relatively constant over time, we can expect that a greater number of primary replacements will result in a greater number of revisions unless some limiting mechanism can be successfully implemented to reduce the future revision burden.
          Article 0 comments Cited 196 times – based on 0 reviews     Review now
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            Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components.

            C Anderson Engh, K Suthers, P Massin (1990)
            Certain roentgenographic signs have value in predicting the fixation of a cementless femoral component to bone by osseointegration. Other signs have value in predicting the gross stability of a cementless femoral component. The authors have determined the specificity and sensitivity of the signs for osseointegration in cases in which the histologic fixation has been confirmed after implant removal. The authors have also determined the specificity and sensitivity of the signs for gross implant stability in cases in which the stability has been confirmed at reoperation. Statistical methods were used to determine a numeric value for each of these roentgenographic signs, and these values were combined into a score. The score was divided into fixation by osseointegration and mechanical implant stability. The two scores were then combined into an overall score. When signs of osseointegration were present, the implant was always stable, and the overall scores were the highest. When signs of osseointegration were absent, the mechanical stability varied, and the scores were lower. A neutral or slightly negative score correlated with failed osseointegration but secondary successful implant stabilization. A very low negative score correlated with gross implant instability. To confirm the validity of the scoring system, the two-year postoperative score was determined for 1005 cases in which the clinical outcome was known. A strong correlation between the presence of symptoms and a low score confirmed the value of the scoring system for diagnosing implant loosening as the cause of symptoms. As a second test, the two-year and five-year postoperative results were compared in the same patients. A high two-year score correlated with durable implant stability through five years. A low two-year score correlated with a higher incidence of late symptomatic loosening.
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              Radiological demarcation of cemented sockets in total hip replacement.

              J G DeLee, J Charnley (1976)
              The frequency of radiological demarcation of the cement-bone junction in the acetabulum after total hip replacement has been examined in 141 Charnley low-friction arthroplasties followed for an average of 10.1 years. Sixty-nine per cent showed demarcation of various degrees and 9.2 per cent of the series showed evidence of progressive migration of the socket. The vast majority of cases with demarcation were symptomless. In most cases where demarcation was accompanied by migration the operation notes suggested a technical explanation and in three cases low-grade sepsis was responsible. The fact that nearly 30 per cent of cases showed no demarcation even after 10 years supports the idea that there is no fundamental defect in the principle of employing cement in the acetabulum. Better surgical technique may increase the number of cases showing no demarcation.
              Article 0 comments Cited 159 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Hip Pelvis
                Journal ID (iso-abbrev): Hip Pelvis
                Journal ID (publisher-id): HP
                Title: Hip & Pelvis
                Publisher: Korean Hip Society
                ISSN (Print): 2287-3260
                ISSN (Electronic): 2287-3279
                Publication date (Print): December 2015
                Publication date (Electronic): 30 December 2015
                Volume: 27
                Issue: 4
                Pages: 223-231
                Affiliations
                Department of Orthopedic Surgery, Inha University School of Medicine, Incheon, Korea.
                Author notes
                Address reprint request to Kyoung-Ho Moon, MD, PhD. Department of Orthopedic Surgery, Inha University Hospital, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea. TEL: +82-32-890-3043, FAX: +82-32-890-3047, moon@ 123456inha.ac.kr
                Article
                DOI: 10.5371/hp.2015.27.4.223
                PMC ID: 4972793
                PubMed ID: 27536630
                SO-VID: 3474bb28-db67-4dd3-9bd8-e8379e93c5be
                Copyright © Copyright © 2015 by Korean Hip Society
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 26 May 2015
                Date revision received : 02 November 2015
                Date accepted : 16 November 2015
                Categories
                Subject: Original Article

                Keywords: revision total hip arthroplasty,ceramic articulation
                Data availability:
                Keywords: revision total hip arthroplasty, ceramic articulation

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