Volume 6, 2020
Special Issue: "HIP and KNEE Replacement" Guest Editors: C Batailler, S Lustig, J Caton
|Number of page(s)||6|
|Published online||04 August 2020|
Early low complication rate of ceramic-on-ceramic total hip arthroplasty by direct anterior approach
Department of Orthopaedic Surgery, Lyon North University Hospital, Lyon, France
2 Department of Orthopaedic Surgery, Western Health, Melbourne, Australia
3 Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, VIC, Australia
*Corresponding author: firstname.lastname@example.org
Accepted: 21 July 2020
Introduction: Ceramic-on-ceramic couplings are an alternative bearing surface to reduce the problems related to polyethylene wear and debris. However, ceramic articulations have their own risk of unique complications: fracture, squeaking, or dislocation. Few studies have assessed the outcomes of ceramic-on-ceramic total hip arthroplasties (THA) by direct anterior approach (DAA). The aim was to evaluate the early complications and revision rate of ceramic-on-ceramic THA by DAA. Material: A retrospective single-center study of 116 consecutive THAs was performed by DAA (106 patients) with ceramic-on-ceramic bearing from January 2015 to February 2018 with a minimum 24 months of follow-up. No patients were lost to follow-up. The mean age was of 55.3 years ± 11.3. The same cementless acetabular shell with a Biolox Delta ceramic insert and head were used. The complication and revision rates were collected at the last follow-up. The positioning of the acetabular implant was assessed on standard radiographs. Postoperative clinical outcomes were assessed by the Harris Hip Score. Results: At a mean follow-up of 31.9 months ± 5.5, no THA was revised. Five patients had late complications: 3 squeaking (2.6%) and 2 psoas impingements (1.7%) and were managed conservatively. All patients had satisfactory bony ingrowth of acetabular component, with no radiolucent lines and no osteolysis. Eight patients (6.9%) had an anterior overhang of the cup. The mean overhang for these patients was 4.1 mm. 111 hips (96%) were perceived as forgotten or having no limitations. Conclusion: This ceramic-on-ceramic coupling and shell by DAA produced excellent clinical outcomes and implant survival rate at a minimum two-year follow-up study. No serious complication was observed during the follow-up.
Key words: Total hip arthroplasty / Acetabular cup / Ceramic-on-ceramic / Complications / Direct anterior approach
© The Authors, published by EDP Sciences, 2020
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