Background Total hip arthroplasty (THA) with ceramic-on-ceramic (CoC) was created to minimise wear debris and aseptic loosening. A decade ago, a meta-analysis showed a 10-year survival rate of just 89%. Based on the excellent tribology of the current CoC, significant improvement of implant survivorship is expected. In patients younger than 60, we conducted a meta-analysis to assess 10-year survival and complications after using current primary CoC THA. Materials and methods PubMed, Scopus, EMBASE, Virtual Health Library, and Cochrane Library were used to scan for published trials that met the inclusion criteria until January 2019. The qualified studies were subjected to a systematic review and proportional analysis, and the randomised controlled trials (RCTs) were included in a comparison meta-analysis. Results Thirteen studies were included 156 findings. The total number of hips was 2278. Nine studies were cohort, and four were RCTs between ceramic and polyethylene cups. The analysis revealed an average age of 44 years (range 24–54). The 10-year survival 96% (95% CI; 95.4–96.8%), aseptic loosening rate 0.516. (95% CI; 0.265–0.903), ceramic fracture rate 0.620 (95% CI; 0.34–1.034) and squeaking rate 2.687 (95% CI; 1.279–4.593). A comparison meta-analysis revealed the risk ratio (RR) for revision was 0.27 (95% CI; 0.15–0.47), and for aseptic loosening 0.15 (0.03–0.70) favouring CoC, while RR for component fracture was 1.62 (95% CI; 0.27–9.66) favouring the polyethylene. Conclusion In patients under sixty, current CoC THAs are correlated with better 10-year outcomes than before and have high survivorship rates. Level of evidence: Level I.

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In the orthopedic literature, combined acetabular and femoral neck fractures with intrapelvic femoral head dislocation are rare. A 2014 study found minimal occurrences. [1] Moore [2] was the first to describe this injury configuration after post-mortem examination of a patient with a pelvic injury in 1851. Stewart and Milford [3] described only one intrapelvic femoral head dislocation case in their large series. Judet et al. [4] reported only two cases, whereas the other authors did not encounter this injury pattern in their case studies. [5,6] This complex injury has only been managed in four cases in the English literature. [7][8][9][10] Two more cases were described in two more Spanish publications. [11,12] Meinhard et al. [7] were the first to describe the management and follow-up of a single case treated with open reduction and internal fixation Combined central acetabular and femoral neck fractures with intrapelvic femoral head dislocation is an infrequent situation that provides a problematic condition for surgeons attempting to reconstruct the hip joint. Herein, we report two cases involving central acetabular fracture-dislocation combined with intrapelvic dislocation of a fractured femoral neck. Each case involved associated injuries that made primary total hip arthroplasty (THA) impossible and necessitated using the fewest skin incisions possible. As a result, we first attempted a posterior acetabular fixation of both the anterior and posterior columns with intra-articular plating of the anterior column. Finally, a cementless acetabular cup was implanted. There were no complications identified during the stages of reconstruction up to and including THA. The two patients̓ final Harris Hip scores were 98 for the first patient (at five years), and 91 for the second patient (at 1 ½ years). In conclusion, staged reconstruction of the hip joint with intra-articular acetabular plating does not weaken the acetabular bone that can accept insertion of THA with cementless biological acetabular fixation without complications and with an acceptable clinical outcome up to five years.

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Prolonged immobilization of the knee after repair of the patellar tendon can result in decreased patellar mobility, limited flexion, persistent pain, muscle weakness, and patella infra. In contrast, early motion prevents many of these unwanted effects. We evaluated the outcome of surgical repairs augmented by a distally based semitendinosus autograft to allow early mobilization. Between January 2010 and October 2010, 15 patients with patellar tendon ruptures were admitted; their average age was 37 years (range, 28-53). By 6 weeks after surgery, 120 degrees of flexion and brace-free ambulation were reached in most patients. By 6 months, most patients had recovered their preinjury levels of activity. At a minimum follow-up of 24 months, results of surgical repair were assessed with the Lysholm scoring. Five cases were excellent, nine cases were good, and one case was poor. Patella tendon repair augmented by semitendinosus tendon was strong enough to permit early motion and weight bearing with achievement of good and excellent results.