Yoo Jun-Il, Ha Yong-Chan, Kim Dong-Hyun, Lee Young-Kyun, Koo Kyung-Hoi
Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, South Korea.
Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, South Korea.
Indian J Orthop. 2019 Sep-Oct;53(5):637-640. doi: 10.4103/ortho.IJOrtho_416_18.
Contemporary ceramic articulation in total hip arthroplasty (THA) has shown successful clinical and radiologic outcomes at mid-to-long term. Delta ceramic, which includes 24% zirconia, has been developed to reduce the rate of ceramic fracture. However, the phase transformation of the zirconia that might cause surface roughness, ceramic wear, and subsequent osteolysis remains a concern. The purpose of this study was to evaluate clinicoradiological outcomes, ceramic-related complications, and survivorship of THA with the use of hybrid ceramic bearing; BIOLOX delta liner-on-BIOLOX forte head articulation at a minimum followup of 10 years.
One hundred cementless THAs (85 patients) were performed with the use of 36-mm hybrid ceramic bearing. The thickness of the delta ceramic liner was 4-6 mm. Four patients (4 hips) were lost and six patients (6 hips) died within 10 years after the operation. Thus, the remaining 75 patients (90 hips) were followed up for 10-12 years. There were 43 men and 32 women. The mean age of these patients at the index operation was 58 years (21-78 years).
There were no fractures of ceramic liner or head. There was no measurable ceramic wear, and neither pelvic nor femoral osteolysis was identified. All acetabular and femoral components were bone-ingrown. Three (3/90, 3.3%) patients noted noise of clicking sound. The mean Harris hip score was 87 points (range 72-99 points) at the time of final followup. THA survivorship with revision surgery as an endpoint was 97.8% (95% confidence interval: 91.4%-99.8%).
The long term result of cementless THA with the use of a large BIOLOX forte head on the BIOLOX delta liner showed an encouraging result. Wear or osteolysis associated with composite of 24% zirconia in the fourth-generation ceramic was not observed at a minimum followup of 10 years.
当代全髋关节置换术（THA）中的陶瓷关节面在中长期显示出成功的临床和放射学结果。已开发出含24%氧化锆的Delta陶瓷，以降低陶瓷骨折率。然而，氧化锆的相变可能导致表面粗糙度、陶瓷磨损及随后的骨溶解，这仍是一个令人担忧的问题。本研究的目的是评估使用混合陶瓷轴承的THA的临床放射学结果、陶瓷相关并发症及生存率；即BIOLOX delta内衬与BIOLOX forte股骨头关节面，至少随访10年。
使用36毫米混合陶瓷轴承进行了100例非骨水泥型THA（85例患者）。Delta陶瓷内衬厚度为4 - 6毫米。4例患者（4髋）失访，6例患者（6髋）在术后10年内死亡。因此，其余75例患者（90髋）随访了10 - 12年。其中男性43例，女性32例。这些患者初次手术时的平均年龄为58岁（21 - 78岁）。
陶瓷内衬或股骨头均无骨折。未检测到陶瓷磨损，也未发现骨盆或股骨骨溶解。所有髋臼和股骨组件均骨长入良好。3例（3/90，3.3%）患者注意到有弹响。末次随访时Harris髋关节平均评分为87分（范围72 - 99分）。以翻修手术为终点的THA生存率为97.8%（95%置信区间：91.4% - 99.8%）。
在BIOLOX delta内衬上使用大尺寸BIOLOX forte股骨头的非骨水泥型THA的长期结果令人鼓舞。在至少10年的随访中，未观察到与第四代陶瓷中24%氧化锆复合物相关的磨损或骨溶解。
