title: Incidence of Ceramic Liner Malseating After Ceramic-on-Ceramic Total Hip Arthroplasty Associated With Osteolysis: A 5- to 15-Year Follow-Up Study.
abstract: The aim of our study was to evaluate the clinical and radiographic outcomes of malseating of the acetabular liner in ceramic-on-ceramic total hip arthroplasty (THA).
  
  
  
  Outcomes for 160 ceramic-on-ceramic THAs, contributed by 116 women and 39 men, were evaluated. Clinical and radiographic measurements were obtained over a 5- to 15-year follow-up for analysis.
  
  
  
  Liner malseating was identified in 20% of cases. Outcomes for 32 cases with liner malseating (group A) were compared to outcomes for 128 joints with correct liner seating (group B). The Harris hip score at the last follow-up was 90.1 for group A and 89.6 for group B. Osteolysis was identified in 5 cases in group A (15.6%), compared to 3 cases in group B (P < .001). No significant between-group differences were identified with regard to ceramic fracture, audible squeaking, loosening of components, and revision THA. The mean annual liner wear rate was comparable between groups, 0.0045 mm/y for group A and 0.0039 mm/y for group B. The 10-year Kaplan-Meier survivorship, based on an end point of revision THA, was 100% for group A and 99.0% for group B.
  
  
  
  Over a moderate-length follow-up of 5-15 years, malseating of the acetabular liner was not associated with negative clinical outcomes or THA survivorship. Malseating did increase the incidence of osteolysis, a risk factor for adverse effects. Long-term follow-up studies are needed to fully quantify the effects of malseating of the acetabular liner.
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 Orthopaedic 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: D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000368:Aged; D000497:Alloys / Q000737:chemistry; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D002516:Ceramics; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000209:etiology*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012307:Risk Factors; D014025:Titanium / Q000737:chemistry; D016896:Treatment Outcome
chemical_list: D000497:Alloys; D014025:Titanium
keywords: ceramic-on-ceramic bearings; complication; liner malseating; long-term follow-up; total hip arthroplasty