Ceramic-On-Ceramic Implants in Total Hip Arthroplasty

Clifford W. Colwell; J.A. D'Antonio; W.N. Capello; M.E. Hardwick

doi:10.4028/www.scientific.net/KEM.284-286.1003

Paper Titles

Bone-Bonding Ability of Ce-TZP/Al₂O₃ Nanocomposite with a Microporous Surface and Calcium Phosphate Coating
p.987

Phase Stability of Zirconia and Alumina/Zirconia Composite Heads against UHMWPE Liners in a Temperature-Controlled Hip Simulation Study
p.991

Third-Body-Wear as a Risk Factor in Joint Endoprosthetics
p.995

Investigation of Monoclinic Content on Clinically Retrieved Zirconia Heads
p.999

Ceramic-On-Ceramic Implants in Total Hip Arthroplasty
p.1003

Subcritical Crack Growth Resistance of Low Temperature Degradation-Free Zirconia/Alumina Composites for Medical Applications
p.1007

Wear Behaviors of UHMWPE against LTD-Free Zirconia/Alumina Composites
p.1011

Nanostructured Diamond Coated CoCrMo Alloys for Use in Biomedical Implants
p.1015

Investigations of the Mechanical Properties of an Alumina Toughened Zirconia Ceramic for an Application in Joint Prostheses
p.1019

HomeKey Engineering MaterialsKey Engineering Materials Vols. 284-286Ceramic-On-Ceramic Implants in Total Hip...

Ceramic-On-Ceramic Implants in Total Hip Arthroplasty

Abstract:

Alumina ceramic is an excellent material for biologic implantation. Decreased particulate wear debris should increase implant longevity. The purpose of this study is to examine clinical and radiological results of ceramic-on-ceramic hip implants compared to cobalt chrome on polyethylene. Four cementless systems were compared, three alumina-on-alumina bearing systems: System I, porous coated cup; System II, hydroxyapatite-coated cup; Trident system, hydroxyapatite-coated cup with metal sleeve backing on ceramic cup liner; and System III (control), porous-coated cup with polyethylene and cobalt chromium bearing system. Patients were randomized to receive System I, II, or III. Trident patients were not randomized. Examinations are performed at 6 months, 1 year and yearly thereafter including x-rays, clinical exam and Harris Hip Score (HHS). Minimum 24-month followup was performed in 562 ceramic hips and 154 control hips. Age, height, weight, gender and diagnosis were similar in all groups. HHS was rated good/excellent by 95 percent of ceramic hips and 97 percent of control hips. Radiographic results demonstrated radiolucency in Femoral Gruen Zone 1 in 3.8 percent (18/474) of ceramic hips and in 8 percent (10/128) of control hips. Unstable acetabular components were reported in none of ceramic hips and in 3.2 percent (5/154) of control hips. Revision was performed in 7 (1.2 percent) ceramic hips, none due to failure of ceramic materials, and in 9 (5.8 percent) control hips. Alumina ceramic materials show promise, but continued evaluation of long-term clinical results is needed.