title: Cementless total hip arthroplasty using Biolox®delta ceramic-on-ceramic bearing in patients with osteonecrosis of the femoral head.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the results of cementless total hip arthroplasty (THA) using a 32 mm or larger Biolox®delta ceramic-on-ceramic (CoC) bearing in patients with osteonecrosis of the femoral head after a minimum of 5 years of follow-up.
  
  
  METHODS
  We retrospectively analysed 44 patients (53 hips) who underwent cementless THA using Biolox®delta CoC bearing. There were 33 men (40 hips) and 11 women (13 hips) with the mean age of 49 years. A 36 mm head was used in 42 (79%) of 53 hips and a 32 mm head was used in 11 hips with smaller acetabular shells. The mean duration of follow-up was 5.3 years (range 5-6 years).
  
  
  RESULTS
  The mean Harris Hip Score improved from 50 points preoperatively to 97 points at final follow-up (p&lt;0.001). All acetabular and femoral components showed radiographic evidence of osseointegration. No osteolysis was observed. No patients sustained ceramic fracture. An audible hip noise was identified in 2 (4%) of the 53 hips (1 squeaking and 1 clicking). Survivorship with revision for any reason at a minimum of 5 years was 100% in the best-case scenario and 95 % in the worst-case scenario.
  
  
  CONCLUSIONS
  The minimum 5-year results of cementless THA using a 32 mm or larger Biolox®delta CoC bearing in patients with osteonecrosis of the femoral head were encouraging with excellent survivorship. However, it was also found that the risk of noise development remains even for the new alumina matrix composite ceramic.
authors: Department of Orthopaedic Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul - Korea.
authors: Seung-Jae
authors: SJ
authors: Lim
authors: Department of Orthopaedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon - Korea.
authors: Sang-Min
authors: SM
authors: Kim
authors: Department of Orthopaedic Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul - Korea.
authors: Dong-Wook
authors: DW
authors: Kim
authors: Department of Orthopaedic Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul - Korea.
authors: Young-Wan
authors: YW
authors: Moon
authors: Department of Orthopaedic Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul - Korea.
authors: Youn-Soo
authors: YS
authors: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002516:Ceramics; D005260:Female; D005271:Femur Head Necrosis / Q000175:diagnosis / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011859:Radiography / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult