title: Primary total hip arthroplasty using 3rd generation ceramic-on-ceramic articulation.
abstract: OBJECTIVE
  Ceramic-on-ceramic (CoC) is currently a popular bearing combination in young patients in primary total hip arthroplasty (THA). The purpose of this study was to evaluate clinical and radiographic results and complications of cementless THA with 3rd generation CoC articulation.
  
  
  METHODS
  From April 2001 to January 2008, 310 primary THAs were performed in 300 patients using 3rd generation CoC articulation. The mean follow-up period was 8.9 years and the mean age at index surgery was 54.6 years. Patient clinical outcome was evaluated with the Harris Hip Score. Radiographic evaluations was performed to analyse osteolysis, implant fixation and loosening.
  
  
  RESULTS
  Mean Harris Hip Score at last follow-up was 95.4 (76-100). Radiographic analysis demonstrated no evidence of stem or cup loosening and there were no cases of osteolysis. Ceramic wear was not detectable on the plain radiograph. Complications requiring revision occurred in 12 cases; 2 ceramic head fractures, 4 dislocations, 2 deep infections and 4 cases of periprosthetic fracture. The cohort had an overall revision rate of 3.9%.
  
  
  CONCLUSIONS
  Clinical outcomes using cementless THA with 3rd generation CoC articulation were satisfactory. Although the mechanical properties of ceramic materials have improved, there are still problems such as ceramic fracture and squeaking. More clinical study and investigation for alternative bearing are necessary to reduce complications. 4th generation CoC or ceramic on cross linked polyethylene may address some of these issues.
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Inha University, Incheon - Korea.
authors.forename: Beom H
authors.initials: BH
authors.lastname: Seo
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Inha University, Incheon - Korea.
authors.forename: Dong J
authors.initials: DJ
authors.lastname: Ryu
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Inha University, Incheon - Korea.
authors.forename: Joon S
authors.initials: JS
authors.lastname: Kang
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Inha University, Incheon - Korea.
authors.forename: Kyoung H
authors.initials: KH
authors.lastname: Moon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D002516:Ceramics; D005260:Female; D006621:Hip Joint; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult