title: Mid-term results of third-generation alumina-on-alumina ceramic bearings in cementless total hip arthroplasty: a ten-year minimum follow-up.
abstract: BACKGROUND
  Alumina ceramic-on-ceramic bearings have gained popularity in hip arthroplasty because of their properties of low wear and chemical inertness. In a previous study, we reported the excellent clinical results in a series of cementless ceramic-on-ceramic primary total hip arthroplasties at a minimum of five years of follow-up. The purpose of the present study was to determine the results in the same patient cohort at a minimum of ten years of follow-up.
  
  
  METHODS
  A series of 301 consecutive primary cementless total hip arthroplasties was assessed clinically and radiographically. Clinical information was available for 244 hips in 227 surviving patients at a minimum of ten years of follow-up, and radiographic information was available for 184 hips in 172 patients.
  
  
  RESULTS
  Twenty-six (9.2%) of the patients had died of an unrelated cause and eight (2.7%) had undergone revision arthroplasty by the time of the latest follow-up. The average Harris hip score was 94 points, with 95% (232) of the patients having an excellent or good result and <4% (nine) having moderate residual pain. All radiographic assessments showed evidence of stable osseous ingrowth. Nine revisions had been performed, including four femoral component revisions due to periprosthetic fracture, one femoral revision due to aseptic loosening, one femoral revision secondary to a femoral shortening osteotomy for nerve palsy, two acetabular cup revisions due to psoas tendinitis, and a repeat revision in one of the patients with psoas tendinitis due to acetabular osteolysis. The overall survival rate of the implants was 98% (95% confidence interval, 94.2% to 99.6%) at ten years with revision for any reason as the end point.
  
  
  CONCLUSIONS
  The patients in our series had a good implant survival rate, good function, a low implant wear rate as reported in the previous study, and no further radiographic evidence of failure at ten years after cementless primary total hip arthroplasty with alumina ceramic-on-ceramic bearings.
authors.affiliation: Specialist Orthopaedic Group, Suite 1.08, 3-9 Gillies Street, North Sydney, NSW 2060, Australia. ericyeung259@yahoo.co.uk
authors.forename: Eric
authors.initials: E
authors.lastname: Yeung
authors.forename: Paul Thornton
authors.initials: PT
authors.lastname: Bott
authors.forename: Rishi
authors.initials: R
authors.lastname: Chana
authors.forename: Mark P
authors.initials: MP
authors.lastname: Jackson
authors.forename: Ian
authors.initials: I
authors.lastname: Holloway
authors.forename: William L
authors.initials: WL
authors.lastname: Walter
authors.forename: Bernard A
authors.initials: BA
authors.lastname: Zicat
authors.forename: William K
authors.initials: WK
authors.lastname: Walter
mesh_terms: D000537:Aluminum Oxide; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000537:Aluminum Oxide