Long-term results of 32-mm alumina-on-alumina THA for avascular necrosis of the femoral head

Solarino, Giuseppe; Piazzolla, Andrea; Notarnicola, Angela; Moretti, Luigi; Tafuri, Silvio; Giorgi, Silvana De; Moretti, Biagio

doi:10.1007/s10195-011-0174-7

Cited by 31 publications

(19 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found that the mean Harris hip score was 93 points at a mean followup of 6.5 years. Our results were comparable to those in other reports of THA using 32-mm third-generation alumina ceramic-on-ceramic bearings [18,21,30,31]. The mean Harris hip score has ranged from 89 to 97 points at a mean followup of 8.1 years (range, 6.2-12.9 years) ( Table 3).…”

Section: Discussionsupporting

confidence: 88%

Primary Ceramic-on-ceramic Total Hip Arthroplasty Using a 32-mm Ceramic Head With a Titanium-alloy Sleeve

Lim

Jang

Kim

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Modern ceramic-on-ceramic bearings have become attractive alternatives to conventional polyethylene in total hip arthroplasty (THA) as a result of their low wear and minimal particle production. However, 28-mm heads in ceramic-on-ceramic bearing couples have been associated with ceramic fracture. To address these issues, 32-mm and larger ceramic heads with a titanium-alloy sleeve have been introduced, although limited data are available on their durability and clinical outcomes. Questions/purposes We determined (1) the survivorship of the primary ceramic-on-ceramic THA using a 32-mm ceramic head with a titanium-alloy sleeve at a minimum followup of 5 years; (2) Harris hip scores; (3) the incidence of ceramic fracture and noisy hip; and (4) the proportion of hips showing radiographic evidence of osteolysis. Methods From November 2005 to August 2009, we performed 301 ceramic-on-ceramic THAs using a 32-mm ceramic head with a titanium-alloy sleeve in 270 patients. Of these, 12 patients (12 hips [4%]) died from problems unrelated to surgery and 13 patients (15 hips [5%]) were lost during followup before a minimum of 5 years had been reached, leaving 245 patients who had 274 THAs with a minimum followup of 5 years (mean, 6.5 years; range, 5-9 years) in this retrospective analysis. During the study period, 30% (301 of 997 hips) were performed with this articulation based on the operating surgeon's discretion. The mean patient age at the time of surgery was 55 years (range, 16-82 years). All operations were performed at a single center. All of the ceramic implants were hot isostatic-pressed, laser-marked, proof-tested third-generation alumina. We determined the implant survival, Harris hip scores, incidence of ceramic fracture or noisy hips (based on a questionnaire), and presence of osteolysis. Results The survival rate of ceramic-on-ceramic bearings in primary THA using a 32-mm ceramic head with a titanium-alloy sleeve was 98% (95% confidence interval, 96%-100%) at 9 years. The Harris hip score improved from a mean of 47 points preoperatively to 93 points at last followup. One ceramic head fractured at 6 years postoperatively. No ceramic liners fractured. Audible hip clicking and squeaking were identified in four hips and one hip, respectively. Osteolysis was detected in three hips, but none had symptoms. Conclusions Primary ceramic-on-ceramic THA using a 32-mm ceramic head with a titanium-alloy sleeve has a survivorship of 98% at 9-year followup. Nevertheless, surgeons should be aware of the potential risks of ceramic

show abstract

Section: Discussionsupporting

confidence: 88%

Primary Ceramic-on-ceramic Total Hip Arthroplasty Using a 32-mm Ceramic Head With a Titanium-alloy Sleeve

Lim

Jang

Kim

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…One study done before 1990 demonstrated that total hip arthroplasty in patients with osteonecrosis had a 17% revision rate at a mean of nine years, while total hip arthroplasties in studies done after 1990 had a 3% revision rate at a mean follow-up of six years 127 . Excellent survivorship at follow-up intervals of greater than ten years suggests that osteonecrosis does not lead to inferior outcomes with modern techniques and implants 273,278,279,285,[287][288][289]292,296,298 . Recent radiostereometric analysis studies have shown low wear rates and excellent survivorship rates at ten years postoperatively [305][306][307] .…”

Section: Total Hip Arthroplastymentioning

confidence: 99%

Nontraumatic Osteonecrosis of the Femoral Head: Where Do We Stand Today?

Mont

Cherian

Sierra

et al. 2015

The Journal of Bone and Joint Surgery

443

436

View full text Add to dashboard Cite

➤ Although multiple theories have been proposed, no one pathophysiologic mechanism has been identified as the etiology for the development of osteonecrosis of the femoral head. However, the basic mechanism involves impaired circulation to a specific area that ultimately becomes necrotic.➤ A variety of nonoperative treatment regimens have been evaluated for the treatment of precollapse disease, with varying success. Prospective, multicenter, randomized trials are needed to evaluate the efficacy of these regimens in altering the natural history of the disease.➤ Joint-preserving procedures are indicated in the treatment of precollapse disease, with several studies showing successful outcomes at mid-term and long-term follow-up.➤ Studies of total joint arthroplasty, once femoral head collapse is present, have described excellent outcomes at greater than ten years of follow-up, which is a major advance and has led to a paradigm shift in treating these patients.➤ The results of hemiresurfacing and total resurfacing arthroplasty have been suboptimal, and these procedures have restricted indications in patients with osteonecrosis of the femoral head.

show abstract

“…Issa et al [29••] assessed the outcomes in patients with ON who had undergone core decompression (n=19 hips) versus 45) between both cohorts. Therefore, the authors concluded that undergoing a prior core decompression did not negatively impact those who may eventually require THA.…”

Section: Core Decompressionmentioning

confidence: 99%

Outcomes of total hip arthroplasty in patients with osteonecrosis of the femoral head—a current review

Pierce

Elmallah

Jauregui

et al. 2015

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

The purpose of this review was to analyze (1) patient-reported outcomes and implant survivorship of osteonecrosis (ON) patients following total hip arthroplasty (THA), (2) if prior hip-preserving procedures influence these outcomes, (3) if resurfacing procedures alter outcomes; and (4) how these outcomes may have been impacted by the choice of different bearing surfaces. Today, with implant innovations such as cementless constructs, ceramic bearing surfaces, and highly cross-linked polyethylene, ON patients derive great benefit and have high survivorship following THA. Most studies have shown that previous hip-preserving procedures do not have a deleterious effect on outcomes. Literature on the use of ceramic and highly cross-linked polyethylene bearing surfaces have shown that these implant designs are useful in younger and more active patients. Future research should evaluate the long-term outcomes and survivorship of these new THA constructs.

show abstract

Long-term results of 32-mm alumina-on-alumina THA for avascular necrosis of the femoral head

Cited by 31 publications

References 39 publications

Primary Ceramic-on-ceramic Total Hip Arthroplasty Using a 32-mm Ceramic Head With a Titanium-alloy Sleeve

Primary Ceramic-on-ceramic Total Hip Arthroplasty Using a 32-mm Ceramic Head With a Titanium-alloy Sleeve

Nontraumatic Osteonecrosis of the Femoral Head: Where Do We Stand Today?

Outcomes of total hip arthroplasty in patients with osteonecrosis of the femoral head—a current review

Contact Info

Product

Resources

About