title: Contemporary alumina-on-alumina total hip arthroplasty performed in patients younger than forty years: a 5-year minimum follow-up study.
abstract: Ceramic-on-ceramic bearing surfaces in total hip arthroplasties (THAs) are an attractive alternative coupling and may offer a promising option for young active patients. We evaluated the clinical results of 72 contemporary primary cementless alumina-on-alumina THAs performed in 61 patients younger than 40 years (mean age, 30 years), after a 5-year minimum follow-up. Most patients (97%) were able to return to their prearthritic activity levels, and none changed occupation because of a postoperative hip joint problem. No implant loosened radiographically and no stem or cup was revised. Ceramic wear was undetectable in 24 hips, where differentiation of the femoral head from the cup was possible on radiographs and no osteolysis was observed. One ceramic fracture following a major motor vehicle accident and a recurrent subluxation-associated ceramic liner edge fracture attributed to inadequate hip muscle tone occurred. We believe that this alternative articulation offers a promising option for young active patients. However, our findings also suggest that contemporary ceramic implant fracture is not a potential, but a real danger. Careful preoperative patient evaluation, proper indications for ceramic bearings, and meticulous surgical techniques are recommended to minimize the possibility of modern ceramic failure.
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jeong Joon
authors.initials: JJ
authors.lastname: Yoo
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Kim
authors.forename: Kang Sup
authors.initials: KS
authors.lastname: Yoon
authors.forename: Kyung-Hoi
authors.initials: KH
authors.lastname: Koo
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Kim
authors.forename: Kwang Woo
authors.initials: KW
authors.lastname: Nam
authors.forename: Hee Joong
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000537:Aluminum Oxide; D019644:Arthroplasty, Replacement, Hip; D001672:Biocompatible Materials; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D013997:Time Factors
chemical_list: D001672:Biocompatible Materials; D000537:Aluminum Oxide