Cementless Total Hip Arthroplasty Using a Ceramic on Ceramic Bearing Surfaces in Patients 60 or More Years Old

ABSTRACT

PURPOSE: To investigate clinical and radiographic results for cementless total hip arthroplasty (THA) using ceramic-on-ceramic articulation in patients over 60 years old. MATERIALS AND METHODS: Between May 2000 and February 2007, we analyzed 44 THAs that used ceramic-on-ceramic articulation in 34 patients aged 60 or older. The mean follow-up duration was 3.2 years; the mean age was 66.8 years. Clinical and radiographic evaluations were carried out. Risk factors for dislocation were evaluated. RESULTS: Final Harris hip scores increased to an average of 90 points from an average of 51 points preoperatively. Radiographic findings demonstrated that fixations around the stems and the acetabular cups were stable. There was no aseptic loosening and osteolysis around the implants. There were 10 cases of posterior dislocation within 3 months postoperatively. Two revisions were done, one due to a recurrent dislocation and one to a ceramic head fracture. Risk factors for dislocation were ASA score, cup anteversion angle and total anteversion angle. CONCLUSION: Cementless THAs using ceramic-on-ceramic articulation for patients aged sixty or more elicits good clinical and radiographic results. Because of the high rate of early dislocation and damage to the ceramic, we call attention to the position of the implants and postoperative management in elderly, debilitated patients.