Preventing ceramic liner fracture after Delta ceramic-on-ceramic total hip arthroplasty
- Authors
- Lee Y.-K.; Lim J.-Y.; Ha Y.-C.; Kim T.-Y.; Jung W.-H.; Koo K.-H.
- Issue Date
- Jul-2021
- Publisher
- Springer
- Keywords
- Ceramic fracture; Delta ceramic-on-ceramic total hip arthroplasty; Noise; Taper angle; Zimmer biomet
- Citation
- Archives of Orthopaedic and Trauma Surgery, v.141, no.7, pp 1155 - 1162
- Pages
- 8
- Journal Title
- Archives of Orthopaedic and Trauma Surgery
- Volume
- 141
- Number
- 7
- Start Page
- 1155
- End Page
- 1162
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/42712
- DOI
- 10.1007/s00402-020-03515-2
- ISSN
- 0936-8051
1434-3916
- Abstract
- Background: The results of total hip arthroplasty (THA) with use of Delta ceramic articulation were successful at medium term follow-up. The use of this newest ceramic has markedly reduced the incidence of ceramic head fractures, but not the incidence of ceramic liner fractures. We tested a hypothesis that the ceramic fractures are prevented by use of a metal shell with 18° inner taper angle and a stem design with a reduced neck geometry. Methods: We conducted a prospective multicenter study of cementless THA with use of 32/36-mm Delta ceramic bearing, Exceed ABT metal shell and Taperloc stem. We evaluated ceramic fracture, noise, clinical results, radiological changes and survival rate at a minimum of 5-year follow-up. Results: From April 2010 to February 2012, 246 patients (274 THAs) were enrolled. Among them, 224 patients (130 men and 94 women, 250 hips) were followed-up for 5–8 years (mean 6.0 years). Ceramic malseating or fracture did not occur in any patient. Eight patients (8 hips, 3.2%) reported noise. Mean Harris hip score was 84 points at the latest follow-up. All acetabular and femoral components had bone-ingrown stability. Two hips were revised due to recurrent dislocation and periprosthetic fracture. The survival rate was 99.6% at 8 years postoperatively. Conclusion: Ceramic fractures can be prevented by a use of (1) 32/36-mm Delta ceramic bearing, (2) metal shell with 18° taper angle, and (2) stem with a reduced neck geometry. However, noise remains a concern of the Delta ceramic bearing. Level of evidence: Therapeutic level II. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
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