Alumina-on-alumina in THA: a multicenter prospective study.
Different bearing surfaces, including alumina-on-alumina, have been used to avoid osteolysis. We prospectively followed 288 patients (319 hips) in which an alumina-on-alumina cup was used with a hydroxyapatite stem. The patients' mean age was 52.7 (range, 14-70 years), and the minimum followup was 3 years (mean, 4.7 years; range, 3-8 years). At final followup, five cups (including one with an alumina liner fracture) and two stems underwent revision. The cumulative probability of not having a revision of one or both components for any cause was 97% (95% confidence interval, 94.7%-99.1%). No patient spontaneously reported any noises from the hip and none reported noises when specifically questioned. All patients who had not undergone revision had good clinical results, but five of these patients had radiographic cup loosening at last followup. These data suggest alumina-on-alumina prostheses had reasonable outcomes after 5 years. One acetabular component fractured from trauma. We observed no linear femoral head penetration. Continued followup will be required to determine if reduction in wear between the alumina-on-alumina bearings results in less osteolysis and loosening.


METHODS
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Garcia-Cimbrelo
Eduardo
E
Hospital la Paz, Pez Austral 13, 5oA, 28007 Madrid, Spain. gcimbrelo@yahoo.es
Garcia-Rey
Eduardo
E
Murcia-Mazón
Antonio
A
Blanco-Pozo
Agustín
A
Martí
Eduardo
E
D000077:Acetabulum / Q000473:pathology; D000328:Adult; D000368:Aged; D000537:Aluminum Oxide; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D017886:Durapatite; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010014:Osteolysis / Q000517:prevention & control; D011446:Prospective Studies; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D016896:Treatment Outcome
D017886:Durapatite; D000537:Aluminum Oxide