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Alshammari MO, de Petrillo G, Epure LM, Huk OL, Zukor DJ, Antoniou J. Outcomes of Ceramic-On-Ceramic Bearing Total Hip Arthroplasty: A Minimum 10-Year Follow-Up Study. J Arthroplasty 2023; 38:S146-S151. [PMID: 37084924 DOI: 10.1016/j.arth.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Although the fourth generation of ceramics has demonstrated excellent clinical results 5 to 6 years postoperatively, concerns over ceramic fracture and squeaking persist and longer-term follow-up (minimum 10 years) studies are warranted. Our study aimed to evaluate the minimum 10-year clinical outcomes and bearing-specific complications of ceramic-on-ceramic (CoC) total hip arthroplasties. METHODS We retrospectively evaluated all patients who underwent primary delta CoC total hip arthroplasty in our institution between January 2004 and February 2013. Demographics, surgical techniques, complications, patient-reported outcomes, and radiographic outcomes were collected and analyzed. For continuous variables, the comparison between groups was conducted using a one-way analysis of variance. Of all 235 patients included in the study, 70.5% were women (190 hips). The mean follow-up period was 12 years (range, 10 to 18). The femoral head sizes of 28- mm, 32 mm, and 36 mm were used in 50, 26, and 197 cases, respectively. Mean acetabular inclination and anteversion angles were 39.2 ± 7.1° and 14.9 ± 3.5°. RESULTS There were 5 hips revised at a mean 4.6 years (range, 0.1 to 7.1). One revision was squeaking-related. Squeaking was also reported by 8 other patients, but did not require revision. Other reasons for revision were early infection in 2 cases, stem loosening in 1 case, and stem fracture in 2 cases. The survival analysis for any causes for revision as an endpoint was 96.7% (95% confidence interval 0.313%-2.57%). CONCLUSION We report excellent mean 12-year follow-up results regarding the complications and survivorship of the fourth generation CoC bearings.
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Affiliation(s)
- Malek O Alshammari
- Department of Orthopaedics, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Gianni de Petrillo
- Department of Orthopaedics, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Laura M Epure
- Department of Orthopaedics, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Olga L Huk
- Department of Orthopaedics, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - David J Zukor
- Department of Orthopaedics, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - John Antoniou
- Department of Orthopaedics, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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Park JW, Ko YS, Lee YK, Ha YC, Koo KH. Ten to 13-Year Results of Delta Ceramic-on-Ceramic Total Hip Arthroplasty in Patients Less Than 30 Years Old. J Bone Joint Surg Am 2023; 105:789-796. [PMID: 36947597 DOI: 10.2106/jbjs.22.01291] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND We previously reported mid-term results of total hip arthroplasty (THA) using Delta ceramic-on-ceramic (CoC) bearings in 72 patients (86 hips) who were <30 years old. Noise was noted in 8 (9.3%) of the hips, no osteolysis or loosening was detected, and no patient required reoperation. The purpose of this study was to assess clinical and radiographic outcomes, complications, and survivorship at >10 years after THA using Delta CoC bearings in patients who were <30 years old. METHODS Cementless THA with a Delta CoC bearing was performed between March 2008 and January 2012 in 91 hips of 76 patients who were <30 years old. Eighty-five hips in 71 patients (44 men and 27 women) with a mean age of 25.9 years (range, 16 to 29 years) at surgery were followed for a mean of 10.9 years (range, 10 to 13 years). RESULTS No ceramic bearings fractured. The incidence of squeaking increased to 5.9% (5 of 85), but the squeaking was not reproducible within individual patients. Periprosthetic osteolysis developed in 3 hips (3 patients): around the stem in 2 and around the metal shell in 1. The stem in 1 hip underwent revision because of a Vancouver type-B2 periprosthetic femoral fracture. One patient with systemic lupus erythematosus underwent irrigation and debridement for periprosthetic joint infection. Survivorship free of reoperation for any reason was 92.4% (95% confidence interval, 82.4% to 100%) at 13 years. CONCLUSIONS The long-term results and survivorship of Delta CoC THA in patients <30 years old were favorable. LEVEL OF EVIDENCE Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Jung-Wee Park
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Young-Seung Ko
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Seoul Bumin Hospital, Seoul, South Korea
| | - Kyung-Hoi Koo
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
- Kay Joint Center, Cheil Orthopaedic Hospital, Seoul, South Korea
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Park JW, Kim HS, Kim KC, Lee YK, Ha YC, Koo KH. A 10- to 12-year follow-up study of delta ceramic-on-ceramic total hip arthroplasty. Arch Orthop Trauma Surg 2023:10.1007/s00402-022-04758-x. [PMID: 36595032 DOI: 10.1007/s00402-022-04758-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND We previously reported five-to-seven-year results of total hip arthroplasty (THA) with the use of delta ceramic-on-ceramic (CoC) bearing. We conducted an extension study with a CT scan at a minimum of 10 years after surgery. METHODS From March 2009 to March 2011, 273 patients (310 hips) received cementless THA with delta CoC bearing, porous-coated cup and hydroxyapatite-coated stem. In this extended study, 252 patients (144 men and 108 women) (288 hips) with a mean age of 49.7 years (16-83) at surgery were followed for a mean of 10.4 years (10-12) with CT scans in 133 hips (46.2%, 133/288). Clinical and radiographic evaluations were made at each follow-up and Kaplan-Meier survival analysis was performed with revision and reoperation as endpoints. RESULTS There were no more ceramic fractures. Compared to mid-term results, the incidence of squeaking and RLLs increased to 3.1% (9/288) and 19.4% (56/288), respectively. The RLL progressed to focal osteolysis in 3 hips (5.4%, 3/56). No hip had detectable wear or prosthetic loosening. Two hips were reoperated due to periprosthetic joint infection and periprosthetic femoral fracture in each. The survivorship decreased to 98.3% (96.7-99.9%) at 12 years. CONCLUSION During the extended follow-up, no additional ceramic fracture occurred, and the incidence of squeak increased by 0.7%. The long-term survivorship of Delta CoC THA was encouraging. However, focal osteolysis occurred around the hydroxyapatite-coated stem in 1% (3/288). LEVEL OF EVIDENCE II (Prospective cohort study).
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Affiliation(s)
- Jung-Wee Park
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 166 Gumi-Ro, Bundang-gu, Seongnam, 463-707, South Korea.,Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Hong-Seok Kim
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea.,Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Ki-Choul Kim
- Department of Orthopaedic Surgery, Dankook University Hospital, Cheonan, South Korea
| | - Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 166 Gumi-Ro, Bundang-gu, Seongnam, 463-707, South Korea. .,Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea.
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Seoul Bumin Hospital, Seoul, South Korea
| | - Kyung-Hoi Koo
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 166 Gumi-Ro, Bundang-gu, Seongnam, 463-707, South Korea.,Department of Orthopaedic Surgery, Kay Joint Center, Cheil Orthopaedic Hospital, Seoul, South Korea
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Davis ET, Remes V, Virolainen P, Gebuhr P, Van Backlé B, Revell MP, Kopjar B. Mid-term outcomes of the R3™ delta ceramic acetabular system in total hip arthroplasty. J Orthop Surg Res 2021; 16:35. [PMID: 33422084 PMCID: PMC7797157 DOI: 10.1186/s13018-020-02192-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/28/2020] [Indexed: 11/10/2022] Open
Abstract
Background Whilst bony fixation of hip replacement has stable solutions, there remains controversy over which bearing best optimizes longevity and function. Ceramic-on-ceramic (CoC) bearing combinations are associated with lower risk of revision due to aseptic loosening and dislocation. Evidence for long-term functional outcomes of modern, 4th generation CoC bearings is limited. The aim of this study was to analyze outcomes and complications of the R3™ Acetabular System (Smith & Nephew, Inc., Cordova, TN, USA) in combination with BIOLOX® Delta ceramic femoral head in patients undergoing primary total hip arthroplasty (THA). Methods Between June 2009 and May 2011, 175 patients (178 hips) were enrolled into a prospective, study at 6 sites in Europe and prospectively followed-up at 3 months and 1, 3, 5, and 7 years postoperative. Results Total WOMAC score improved from 63 (range, 22–91) preoperative to 8 (range, 0–8) at 1-year follow-up and remained unchanged at 7-year follow-up. Modified Harris hip score improved from 45 (range, 10–87) preoperative to 83 (range, 25–100) at 3 months, 91 (range, 42–100) at 1 year, and 92 (range, 46, 100) at 7 years. UCLA Activity Rating Scale score improved from 3.3 (range, 1–8) preoperative to 6.2 (range, 2–8) at 1 year; it marginally declined to 5.8 (range, 3–8) at 7-year follow-up. There were 4 trochanteric fractures and 5 patients died of unrelated reasons. Three hips were revised (2 periprosthetic fractures and 1 subluxation). The 7-year cumulative survival rate was 98.3%. Conclusion Clinical and functional improvements of THA with CoC bearing are maintained at 7 years postoperative. Trial registration ClinicalTrials.Gov, NCT03566082, Registered 10 January 2018—retrospectively registered,
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Affiliation(s)
- Edward T Davis
- The Royal Orthopaedic Hospital, NHS Foundation Trust, Bristol Road South, Northfield, Birmingham, B31 2AP, UK.
| | - Ville Remes
- Department of Orthopedics, HUS Peijaksen sairaala, P.O. Box 900, 00029 HUS, Vantaa, Finland
| | - Petri Virolainen
- Turku University Hospital, Kiinamyllynkatu 4-8, P.O Box 52, 20521, Turku, Finland
| | - Peter Gebuhr
- Orthopaedic Surgeon, Department of Orthopaedics, Hvidovre University Hospital, Copenhagen, Denmark
| | - Bart Van Backlé
- AZ Nikolaas, Sint Niklaas, Regentiestraat, 60, 9100, Sint Niklaas, Belgium
| | - Matthew P Revell
- The Royal Orthopaedic Hospital, NHS Foundation Trust, Bristol Road South, Northfield, Birmingham, B31 2AP, UK
| | - Branko Kopjar
- Department of Health Services, University of Washington, H690C, Health Sciences Building, P.O. Box 357660, Seattle, WA, 98195-7660, USA
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Chen B, Luo Z, Feng X, Pan K, Liu Q, Yang Y. Effect of high-quality care on limb function recovery and quality of life after osteoporotic hip fracture surgery in the elderly. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2021; 21:272-278. [PMID: 34059572 PMCID: PMC8185254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To evaluate the effect of high-quality care on limb function recovery and quality of life (QOL) after osteoporotic hip fracture (OHF) surgery in the elderly. METHODS 116 elderly patients with OHF enrolled in our hospital from January 2017 to December 2019 were assigned into observation group (high-quality care, n=58) and control group (routine care, n=58). After one month of intervention, Harris Hip Score (HHS) and Barthel Index (BI) were used to evaluating limb function and self-care ability, pain intensity numerical rating scale (PINRS) for pain assessment, self-rating anxiety scale (SAS), and self-rating depression scale (SDS) for emotion assessment. Besides, postsurgical complications, QOL and patient satisfaction were examined. RESULTS HHS and BI were higher in observation group (P<0.05); PINRS, SAS and SDS were lower in observation group (P<0.05); incidence of postsurgical complications in the observation group was significantly lower than that in the control group (P<0.05); QOL and patient satisfaction in the observation group were higher than those in the control group (P<0.05). CONCLUSION High-quality care promotes the recovery of limb function, the QOL and the satisfaction of elderly patients.
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Affiliation(s)
- Biying Chen
- Department of Orthopaedics, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Zhen Luo
- Department of Joint and Trauma Surgery, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Xiaolei Feng
- Department of Orthopaedics, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Kaixia Pan
- Department of Orthopaedics, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Qiuqin Liu
- Department of Orthopaedics, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Yexiang Yang
- Department of Joint and Trauma Surgery, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China,Corresponding author: Yexiang Yang, Department of Joint and Trauma Surgery, The Third Affiliated Hospital of Sun Yat-sen University, No.600 Tianhe Road, Tianhe District, Guangzhou 510630, Guangdong Province, P.R. China E-mail:
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