Cementless ceramic total hip arthroplasty: a 5 to 16 year follow-up.
BACKGROUND
Cementless total hip arthroplasty (THA) was invented to replace cemented THA and thus avoided cement disease, which shortened the longevity of implants. Ceramic THA was an early type of cementless THA which was used at our institution for several years. In the literature, reports about ceramic THA are very rare, moreover, the results of THA are controversial. This retrospective study was to report our experience.


METHODS
Seventy-two cementless ceramic THAs were performed and followed for at least 5 years (range, 5 to 16 years; average, 9.8 years) at our institution. Patients ranged in age from 23 to 68 years (average, 45 years) with a male to female ratio of 3 to 1. A modified d'Aubigne and Postels' method was used to evaluate the functional and radiographic outcomes.


RESULTS
Only 51.4% of the cases achieved a satisfactory result. Furthermore, the complication rate was very high, especially for aseptic loosening (34.7%). For ankylosing spondylitis cases, the satisfactory result rate was only 30% (2/7) and the unsatisfactory cases even had a loosening rate of 80% (4/5).


CONCLUSIONS
Compared to other types of cementless THA, the satisfactory result rate with ceramic THA was markedly lower and the complication rate was relatively higher. Therefore, we conclude that cementless ceramic THA is not an ideal implant and its usage should be strictly restricted.
Wu
C C
CC
Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Shih
C H
CH
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002516:Ceramics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000209:etiology; D012189:Retrospective Studies; D013167:Spondylitis, Ankylosing / Q000601:surgery