To evaluate the medium- and long-term effectiveness of the 3rd-generation ceramic-on-ceramic total hip arthroplasty (THA) for end-stage hip disease.
A retrospective analysis was made on the clinical data of 142 patients (148 hips) who underwent the 3rd-generation ceramic-on-ceramic THA between May 2001 and May 2005. There were 78 males and 64 females, aged 57.2 years on average (range, 23-81 years). Preoperative diagnosis was avascular necrosis of femoral head in 73 patients (77 hips), degenerative osteoarthritis in 35 patients (36 hips), femoral neck fracture in 18 patients (18 hips), rheumatoid arthritis in 14 patients (15 hips), and septic hip sequelae in 2 patients (2 hips). The preoperative Harris hip score was 58.3 ± 12.9.
All incisions healed by first intention without complication. All patients were followed up 8.8 years on average (range, 7-12 years). At the last follow-up, the Harris hip score (92.5 ± 10.2) was significantly higher than that at pre-operation (t = -25.29, P = 0.00). At the last follow-up, there were 4 hips with groin pain, 6 hips with thigh pain. Complications occurred in 6 cases (6 hips), including loosening cups in 2 hips, hip dislocation in 2 hips, ceramic head fracture in 1 hip, and squeaking in 1 hip. The revision rate was 1.35% (3/148). X-ray film showed that acetabular cup loosening in 2 hips, discontinuous radiolucent line in 4 hips, and new bone formation in 88 hips; discontinuous radiolucent line around femoral component was observed in 25 hips, endosteal new bone formation in 95 hips, cortical bone hypertrophy in 2 hips, and femoral component subsidence in 9 hips (less than 2 mm).
Third-generation ceramic-on-ceramic THA is an effective treatment for end-stage hip disease, and can achieve satisfactory medium- and long-term effectiveness and a high implant survival rate.