title: Survivorship Between 2 Different Ceramic-on-Ceramic Total Hip Arthroplasty With or Without a Metal-Backed Titanium Sleeve Bearing: A 5- to 14-Year Follow-Up Study.
abstract: The aim of the study was to compare the clinical and radiographic results of consecutive ceramic-on-ceramic bearings with and without a metal-backed titanium sleeve in patients undergoing total hip arthroplasty.
  
  
  
  Eighty-five patients (64 women and 21 men; average age 55.2 years) were included in the A group without sleeve while 147 patients (116 women and 31 men; average age 54.2 years) were included in the B group with sleeve. Clinical and radiologic measurements at follow-up (range, 5-14 years; average, 8.1 years) were analyzed.
  
  
  
  The mean latest postoperative Harris Hip Score was 89.1 for patients from both groups. One joint (1.2%) in the A group displayed ceramic liner fracture, while no incidences of liner fracture occurred in the B group. Audible squeaking was observed in 1 joint (1.2%) in the A group and 1 (0.7%) in the B group. The mean annual liner rate of wear was 0.0049 and 0.0046 mm/y for the A group and B group, respectively. Three joints in the A group (3.5%) required revision total hip arthroplasty because of individual episodes of aseptic cup loosening, ceramic liner fracture, and infection. One joint in the B group (0.7%) required revision because of progressive osteolysis of the proximal femur. Ten-year Kaplan-Meier survivorship, based on an end point of component loosening and bearing failure, was 97.6% for the A group and 99.3% for the B group.
  
  
  
  There were no clinical, radiographic, or survivorship differences between groups.
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yoshitoshi
authors.initials: Y
authors.lastname: Higuchi
authors.affiliation: Department of Hip and Knee Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yukiharu
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Daigo
authors.initials: D
authors.lastname: Komatsu
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Seki
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiguro
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D002516:Ceramics; D005260:Female; D005269:Femur; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008670:Metals; D008875:Middle Aged; D011184:Postoperative Period; D011474:Prosthesis Design / Q000706:statistics & numerical data*; D011475:Prosthesis Failure; D011859:Radiography; D012307:Risk Factors; D000073859:Survivorship; D013997:Time Factors; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D008670:Metals; D014025:Titanium
keywords: ceramic-on-ceramic bearings; long-term follow-up; metal-backed titanium sleeve; total hip arthroplasty; wear