title: Large-diameter Delta ceramic-on-ceramic versus common-sized ceramic-on-polyethylene bearings in THA.
abstract: The higher failure rate of total hip arthroplasty (THA) in young, active patients remains a challenge for surgeons. Recently, larger-diameter femoral heads combined with an alumina matrix composite ceramic (BIOLOX Delta; CeramTec AG, Plochingen, Germany) articulation was developed to improve implant longevity and meet patients' activity demands while reducing the risk of component-related complications. The purpose of this study was to determine whether this new device may provide advantages for young, active patients. A prospective, randomized, controlled trial was conducted on 93 patients (113 THAs) with more than 3 years of follow-up. Patients were randomly divided into a study group (51 THAs) with a 36-mm Delta ceramic-on-ceramic (COC) articulation and a control group (62 THAs) with a common-sized alumina ceramic head on polyethylene liner (COP) articulation. Clinical and radiographic results were collected to compare the outcomes and complications, including implant-related failures, osteolysis, and noises. The large-diameter Delta COC articulation provided greater range of motion improvement (6.1° more), similar Harris Hip Scores, and similar complication rates compared with the alumina COP articulation. This study suggests that in the short term, the large-diameter Delta COC articulation results in better range of motion with no higher complication rates; however, mid-term (8-10 years) or longer follow-up is necessary to determine its superiority in young, active patients.
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Pengde
authors.initials: P
authors.lastname: Cai
authors.forename: Yihe
authors.initials: Y
authors.lastname: Hu
authors.forename: Jie
authors.initials: J
authors.lastname: Xie
mesh_terms: D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000706:statistics & numerical data*; D002516:Ceramics; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006622:Hip Prosthesis / Q000706:statistics & numerical data*; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020959:Polyethylene; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D011474:Prosthesis Design; D020127:Recovery of Function; D016896:Treatment Outcome
chemical_list: D020959:Polyethylene