title: Primary Total Hip Arthroplasty Using Third Generation Ceramic-Ceramic Articulation: Results after a Minimum of Three-years of Follow-up.
abstract: OBJECTIVE
  This study assessed the short term clinicoradiological results of primary total hip arthroplasty using third generation ceramic-ceramic articulation Accolade TMZF femoral stems.
  
  
  METHODS
  Two hundred and seventy two patients (294 hips) with primary total hip arthroplasty using third generation ceramic-ceramic articulation Accolade TMZF femoral stems who had been followed-up for a minimum of 3 years were included. Clinicoradiological results were analyzed and postoperative complications were observed.
  
  
  RESULTS
  At final follow-up, mean Harris hip score was increased from 52 to 94 points. On radiogical evaluation, the average acetabular inclination was 42 degrees and the average acetabular anteversion was 15 degrees. Neither osteolysis nor loosening were observed around the acetabulum or proximal femur. Among 294 acetabular cups, 293 cups (99.66%) achieved stable fixation. Regarding the 294 femoral stems, 286 (97.28%) had bony fixation, 7 (2.38%) had fibrous fixation, and none were found to have unstable stem fixation. Proximal bone resorption was observed in 17 hips (5.78%; only Grade 1) and radiolucent lines were observed in 88 hips (29.93%), however, all were around the distal smooth portion of the stems. Postoperative complications included dislocation in 6 hips (2.04%), heterotopic ossification in 3 hips (1.02%), ceramic fractures in 4 hips (1.36%), superficial infection in 1 hip (0.34%), and squeaking in 8 hips (2.72%).
  
  
  CONCLUSIONS
  The short term clinicoradiological results of primary total hip arthroplasty using third generation ceramic-ceramic articulation and Accolade TMZF femoral stems together with Secur-Fit acetabular cups were satisfactory. However, problems such as ceramic fractures and squeaking after arthroplasty were observed. Additional studies are necessary in order to develop methods that may reduce or eliminate these complications.
authors.affiliation: Department of Orthopedics, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Dong Woo
authors.initials: DW
authors.lastname: Lee
authors.affiliation: Department of Orthopedics, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Sung Kwan
authors.initials: SK
authors.lastname: Hwang
keywords: Harris hip score; Primary total hip arthroplasty; Third generation ceramic-ceramic articulation