Ten- to 14-year results of a ceramic hip prosthesis.

One hundred total hip arthroplasties with a cementless aluminum oxide socket and ball with different types of cemented metal femoral stems were performed from 1974 to 1979. All were primary implantations. These cases were recently reviewed in a ten- to 14-year follow-up evaluation. Despite extensive laboratory testing of the ceramic material, a significant number of cases resulted in a very unfavorable result such as extensive wear, ball fracture, or migration of the socket. Whereas the patients had died or could no longer be traced in the case of 23 prostheses, there were 25 prostheses that had already been exchanged at the time of review for mechanical reasons (two stem fractures, eight ceramic ball fractures) and for component loosening attributable to wear of the alumina components. The remaining 52 prostheses still in place had good clinical results in 80%. However, roentgenographic evaluation of these prostheses revealed signs of loosening in six femoral components and in three sockets. Migration of more than 5 mm was evident in 24 sockets (46% of surviving prostheses). Although this had caused loosening in only three sockets at the time of review, further migration up to the limits of the acetabular region would be a major reason for future failures.