Objective: To investigate the methodology and efficacy evaluation of ceramic on ceramic hip prosthesis in total hip arthroplasty for young patients.
Methods: The clinical data from 65 patients (75 hips) who received ceramic on ceramic hip prosthesis for total hip arthroplasty between February 2004 and September 2006, including unilateral replacement in 55 cases and bilateral replacement in 10 cases. Of 65 patients, there were 41 males and 24 females with an average age of 43.2 years (range, 18-56 years), including 6 cases of femoral head comminuted fractures, 44 cases of aseptic necrosis femoral head, 7 cases of developmental dysplasia of hip with osteoarthritis, 3 cases of congenital dislocation of hip, 2 cases of traumatic arthritis secondary to postoperative acetabulum fracture, 1 case of rheumatoid arthritis, and 2 cases of ankylosing spondylitis. The Harris score was 54.3 +/- 6.7. The disease duration was 1 year and 4 months to 10 years and 7 months with an average of 3 years and 2 months.
Results: Healing of incision by first intention was achieved in all patients; no dislocation, infection, and deep venous thrombosis of lower limbs occurred. All patients were followed up 3 years and 2 months to 5 years and 7 months with an average of 4 years and 9 months. The Harris score was significantly improved to 89.0 +/- 9.4 at last follow-up, showing significant difference when compared with preoperative one (P < 0.01). The mean eversion angle and anteversion angle of the acetabular component were (43.6 +/- 8.4) degrees and (21.5 +/- 3.5) degrees, respectively. In follow-up period, no prosthetic loosening, subsidence, dislocation, and ceramic component fracture occurred. Osteolysis was not found in all the cases.
Conclusion: Ceramic on ceramic hip prosthesis in total hip arthroplasty for young patients can effectively decrease the complications of prosthetic loosening and subsidence caused by wearing of joint interface; the surgical skill is important in decreasing dislocation and fraction of ceramic on ceramic hip prosthesis.