[Cementless ceramic-on-ceramic total hip system].
OBJECTIVE
This is an experimental and clinical study on the use of cementless, ceramic-on-ceramic total hip arthroplasty (THA).


METHODS
In the experimental part, the authors constructed, by means of mathematical analysis of finite elements, surface tension standards for the ceramic liner at various angles of cup inclination, and identified potentials for destruction of the liner. In the clinical trial, they evaluated the outcomes in 50 patients, out of the 249 implanted prostheses, at five-year follow-up.


RESULTS
The experiment showed that a slightly steeper inclination the cup provided physical conditions for increased longevity of the ceramic liner. In the clinical study, no post-operative complications, such as fracture of the acetabulum or femur, and dislocation or break of any ceramic part, were recorded. No infection or loosening of the prosthesis occurred. The patients did not complained of any pain in the hip joint, which is typical of non-cemented THA.


CONCLUSIONS
Ceramic-on-ceramic bearing surfaces show the least wear due to high biocompatibility. Computer-assisted surgery can markedly reduce the risk of incorrect positioning of the acetabular component. In this prospective study, the five-year survival of ceramic-on-ceramic THA in 50 patients free from any complications, whose Harris hip score was 97.4 points, suggests that objections to these prostheses, as raised by some authors, are not justified.


CONCLUSIONS
In our experience the Plasmacup Bicontact ceramic-on-ceramic prosthesis is one of a few options that has a prospect of remaining the only total hip replacement in one's lifetime. Key words: total hip replacement, ceramic-on-ceramic.
Janícek
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I Ortopedická Klinika LF MU, FN U sv Anny, Brno. pavel.janicek@fnusa.cz
Janícek
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Fuis
V
V
Pink
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D019644:Arthroplasty, Replacement, Hip; D002516:Ceramics; D006622:Hip Prosthesis; D006801:Humans; D011474:Prosthesis Design