Massive femoral osteolysis secondary to loosening of a cemented roughened long stem: a case report

Cementless Revision Total Hip Arthroplasty with Ceramic Articulation

Purpose

The results of ceramic-on-ceramic (CoC) bearing surfaces in primary total hip arthroplasty (THA) were well known. However, it was not known in revision THA. The purpose of this study is to report the results of revision THA with ceramic articulation.

Materials and Methods

A total of 112 revision THAs were evaluated. The mean age at the time of surgery was 51.6 years (27.7 to 84.2 years). The mean duration of the follow-up periods was 6.3 years (2.3 to 11.4 years).

Results

The Harris hip scores improved from an average of 56.2 at the index surgery to an average of 93.3 at the last follow-up (P<0.001). None of hips showed osteolysis or ceramic head fracture. One hip showed aseptic loosening in the acetabular component with squeaking that caused a re-revision. There were nine cases of dislocation. The survivorship at 5 years was 94.5% (95% confidence interval, 87.9% to 97.6%) with revision for any reason as the endpoint and 100% with femoral revision.

Conclusion

The ceramic articulation is one of good bearing options for revision THA in patients with a long life expectancy.