Could larger diameter of 4th generation ceramic bearing decrease the rate of dislocation after THA?
- Authors
- Lee, Young-Kyun; Ha, Yong-Chan; Jo, Woo-Lam; Kim, Tae-Young; Jung, Woon-Hwa; Koo, Kyung-Hoi
- Issue Date
- May-2016
- Publisher
- ELSEVIER SCIENCE BV
- Citation
- JOURNAL OF ORTHOPAEDIC SCIENCE, v.21, no.3, pp 327 - 331
- Pages
- 5
- Journal Title
- JOURNAL OF ORTHOPAEDIC SCIENCE
- Volume
- 21
- Number
- 3
- Start Page
- 327
- End Page
- 331
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/7004
- DOI
- 10.1016/j.jos.2016.01.002
- ISSN
- 0949-2658
1436-2023
- Abstract
- Background: Fourth generation (Delta) ceramic bearing was developed to reduce dislocation after total hip arthroplasty (THA) by increasing the head diameter. We tested a hypothesis that 32/36 mm Delta ceramic bearing decreases the dislocation rate. We also evaluated ceramic-related complications and early outcome of this thin liner-on-large head ceramic bearing. Methods: We performed a prospective study on patients who underwent THA with use of 32/36 mm Delta ceramic bearing. The dislocation rate was compared with the historical dislocation rate of third generation 28 mm ceramic bearing. We also evaluated ceramic fracture, squeak, short-term results and survival. Follow-up period was minimum 2 years. Results: Between April 2010 and February 2012, we enrolled 250 consecutive patients (278 hips). All patients received cementless prostheses. Four patients (4 hips) who received metal shells < 46 mm and 28 mm heads were excluded. Three patients died and 2 patients were lost within 2 years. The remaining 241 patients (269 hips) were followed for 24-46 months. There were 142 men (161 hips) and 99 women (108 hips) with a mean age of 53.7 years (range, 17-75 years) at the index operation. Dislocation occurred in three hips (1.1%). An old age was a risk factor for dislocation. Ceramic fracture and squeaking did not occur in any patient. Mean Harris hip score was 90.3 points at the latest follow-up. All acetabular and femoral components had bone-ingrowth stability. No hip had detectable wear or osteolysis. The survival was 99.3% in the best case scenario and 97.8% in the worst at 48 months. Conclusions: Total hip arthroplasty with use of 32/36 mm Delta ceramic bearing showed lower incidence of hip dislocation compared with 28 mm third generation ceramic bearing. A caution should be paid to prevent a fall in senile patients even though a large head is used. The short-term results of THA with this type of ceramic articulation are encouraging and we did not find any ceramic-related complications. (C) 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
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