The Journal of Bone and Joint Surgery (American). 2005;87:530-535.
doi:10.2106/JBJS.D.01753
© 2005 The Journal of Bone and Joint Surgery, Inc.
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 Adult Hip Reconstruction Test 13: Spring 2005
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Alumina-on-Alumina Total Hip Arthroplasty

A Five-Year Minimum Follow-up Study

Jeong Joon Yoo, MD1, Young-Min Kim, MD2, Kang Sup Yoon, MD3, Kyung-Hoi Koo, MD2, Won Seok Song, MD1 and Hee Joong Kim, MD1

1 Department of Orthopaedic Surgery, Seoul National University Hospital, 28 Yongondong, Chongnogu, 110-744, Seoul, Korea. E-mail address for H.J. Kim: oskim{at}snu.ac.kr
2 Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 300 Gumidong, Bundanggu, 463-707, Seongnam, Korea
3 Department of Orthopaedic Surgery, Seoul Municipal Boramae Hospital, 395 Shindaebangdong, Dongjackgu, 156-707, Seoul, Korea

Investigation performed at the Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from the Seoul National University Hospital Research Fund (grant number 06-03-063). None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Ceramic-on-ceramic couplings are attractive alternative bearing surfaces that have been reported to eliminate or reduce problems related to polyethylene wear debris. Disappointing experiences with alumina ceramic bearings in the past have led to many improvements in the manufacture and design of ceramic implants. The purpose of the present study was to report the results of contemporary alumina-on-alumina total hip arthroplasties with regard to wear, osteolysis, and fracture of the ceramic after a minimum duration of follow-up of five years.

Methods: We evaluated the results of a consecutive series of 100 primary alumina-on-alumina total hip arthroplasties that had been performed with use of a metal-backed socket and a cementless stem in eighty-four patients. All of the patients were sixty-five years of age or younger (mean age, forty-one years), and a single surgeon performed all of the procedures. After a minimum duration of follow-up of sixty months, one patient (one hip) had died and four patients (six hips) had been lost to follow-up, leaving a total of seventy-nine patients (ninety-three hips) available for study. All of these patients were evaluated clinically and radiographically with special attention to wear, periprosthetic osteolysis, and ceramic failure.

Results: The mean Harris hip score was 97 points at the time of the latest follow-up evaluation. All prostheses demonstrated radiographic evidence of bone ingrowth. No implant was loose radiographically, and no implant was revised. Ceramic wear was not detectable in the thirty-seven hips in which the femoral head could be differentiated from the cup on radiographs. Periprosthetic osteolysis was not observed in any hip. A fracture of the alumina femoral head and a peripheral chip fracture of the alumina insert occurred in one hip following a motor-vehicle accident.

Conclusions: The results of contemporary alumina-on-alumina total hip arthroplasty with a metal-backed socket and a cementless stem were encouraging after a minimum duration of follow-up of five years. We believe that these improved alumina-on-alumina bearing implants offer a promising option for younger, active patients.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


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