There are limited studies to evaluate long-term clinical and radiographic outcomes of alumina delta ceramic-on-ceramic bearings in cementless total hip arthroplasty (THA). The purpose of this study was to evaluate the clinical and radiographic results, prevalence of osteolysis, squeaking, and fracture of ceramic material associated with the use of the alumina delta ceramic-on-alumina delta ceramic bearing in cementless THA in patients aged <50 years.
We reviewed the cases of 277 patients (334 hips) who underwent a cementless THA using alumina delta ceramic-on-alumina delta ceramic when they were 50 years or younger at the time of surgery. Demographic data; Harris Hip Score; Western Ontario McMaster Universities Osteoarthritis Index; and University of California, Los Angeles activity score were recorded. Radiographic and computerized tomographic evaluations were used to evaluate implant fixation and osteolysis. Squeaking sound and ceramic fracture were documented. The mean follow-up was 13.1 years (range, 10-14).
The mean postoperative Harris Hip Score, Western Ontario and McMaster Universities Osteoarthritis Index score, University of California, Los Angeles activity score were 93 points, 15 points, and 8.6 points, respectively. Two patients had thigh pain (grade 7 points). All acetabular components and all but 2 femoral components were well fixed. Thirty-three hips (10%) exhibited clicking sound, and 2 hips (0.6%) exhibited squeaking sound. No hip had osteolysis or ceramic head or liner fracture.
Our minimum 10-year follow-up results with the use of alumina delta ceramic-on-alumina delta ceramic bearings in patients aged <50 years suggest that cementless THA provides a high rate of survivorship without evidence of osteolysis or fracture of ceramic material.