title: Comparison between 28 mm and 32 mm ceramic-on-ceramic bearings in total hip replacement.
abstract: Large femoral heads have become popular in total hip replacement (THR) as a method of reducing the risk of dislocation. However, if large heads are used in ceramic-on-ceramic THR, the liner must be thinner, which may increase the risk of fracture. To compare the rates of ceramic fracture and dislocation between 28 mm and 32 mm ceramic heads, 120 hips in 109 patients (51 men and 58 women, mean age 49.2 years) were randomised to THR with either a 28 mm or a 32 mm ceramic articulation. A total of 57/60 hips assigned to the 28 mm group and 55/60 hips assigned to the 32 mm group were followed for at least five years. No ceramic component fractures occured in any patient in either group. There was one dislocation in the 32 mm group and none in the 28 mm group (p = 0.464). No hip had detectable wear, focal osteolysis or prosthetic loosening. In our small study the 32 mm ceramic articulation appeared to be safe in terms of ceramic liner fracture.
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 beon-gil, Bundang-gu, Seongnam 463-707, South Korea.
authors.forename: Y K
authors.initials: YK
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, 221 Heukseok-dong, Dongjak-gu, Seoul, 156-756, South Korea.
authors.forename: Y C
authors.initials: YC
authors.lastname: Ha
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 beon-gil, Bundang-gu, Seongnam 463-707, South Korea.
authors.forename: K H
authors.initials: KH
authors.lastname: Koo
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D002516:Ceramics; D005260:Female; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000209:etiology / Q000517:prevention & control*; D006621:Hip Joint / Q000503:physiopathology* / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Head size; Total hip replacement; Bearings; Ceramic; ceramic fracture; dislocation