Unsatisfactory results with a ceramic total hip prosthesis.
We reviewed the results of forty-two total hip replacements that had been done with the self-locking Autophor ceramic total hip prosthesis in thirty-four patients. The patients ranged in age from twenty-five to sixty-seven years (average, forty-eight years). The diagnoses were avascular necrosis (eight patients), degenerative arthritis (nineteen patients), ankylosing spondylitis (one patient), post-traumatic arthritis (two patients), and rheumatoid arthritis (four patients). Seven procedures were revisions: five, of a loose cemented total hip prosthesis and two, of a loose noncemented endoprosthesis. No revision was done for infection. The length of follow-up ranged from twenty-seven to sixty-six months (average, fifty-one months). The patients were evaluated by physical examination, serial radiographs, and questionnaires. The hips were rated with the modified Harris hip score. At the time of follow-up, eleven of the twenty-seven patients who had had a primary hip replacement complained of at least moderate pain that limited activities; however, only three patients had to have a revision. The femoral components had a notable tendency to subside more than five millimeters, and in fifteen hips there was radiographic evidence of progressive loosening. Our experience with the self-locking Autophor ceramic total hip prosthesis has been disappointing. We no longer use it.
Mahoney
O M
OM
Peachtree Orthopaedic Clinic, Piedmont Hospital, Atlanta, Georgia 30367.
Dimon
J H
JH
D000328:Adult; D000368:Aged; D002516:Ceramics; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011183:Postoperative Complications; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D013314:Stress, Mechanical