Low aseptic loosening and revision rate in Zweymüller-Plus total hip arthroplasty with ceramic-on-ceramic bearings

Introduction: Periprosthetic joint infection (PJI) is a serious complication after total hip arthroplasty (THA) and bearing material’s associations to PJI prevalence is largely unknown. The main purposes of this study were to determine if revision for infection varied depending on the type of bearing surface used in primary THA and to study whether patient or implant related factors had an effect on this variation. Methods: A total of 177,237 primary THA procedures from the Australian Registry (AOANJRR) were analysed. 3 bearing surfaces were compared. Metal-on-highly cross-linked polyethylene (MoXP) bearing had been used in 95,129 hips, ceramic-on-highly cross-linked polyethylene (CoXP) in 24,269 hips, and ceramic-on-ceramic (CoC) in 57,839 hips. Revision rates for infection were compared between the 3 groups. Results: Both MoXP and CoXP had a higher revision rate for infection compared to CoC hips (hazard ratio [HR] 1.46 (1.25, 1.72), p < 0.001) and HR 1.42 (1.15, 1.75), p = 0.001 respectively). Patients aged 70 years or less had a lower revision rate for infection when a CoC bearing was used. This difference was independent of sex, and prostheses selection. No difference was evident if the femoral component was cemented or a head size of 28 mm was used. Discussion: In this registry-based material, use of a CoC bearing was associated with a lower risk of revision for infection in patients younger than 70 years when cementless femoral components were used. Further studies are needed to verify this finding.

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Ten-year survival of ceramic-on-ceramic total hip arthroplasty in patients younger than 60 years: a systematic review and meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02828-1 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Ihab Ibraheam El-Desouky ◽

Albaraa Hassan Helal ◽

Ali Mohamed Reda Mansour

Keyword(s):

Systematic Review ◽

Total Hip Arthroplasty ◽

Aseptic Loosening ◽

Hip Arthroplasty ◽

Meta Analysis ◽

Cochrane Library ◽

Fracture Rate ◽

Level Of Evidence ◽

Total Hip ◽

Ceramic On Ceramic

Abstract Background Total hip arthroplasty (THA) with ceramic-on-ceramic (CoC) was created to minimise wear debris and aseptic loosening. A decade ago, a meta-analysis showed a 10-year survival rate of just 89%. Based on the excellent tribology of the current CoC, significant improvement of implant survivorship is expected. In patients younger than 60, we conducted a meta-analysis to assess 10-year survival and complications after using current primary CoC THA. Materials and methods PubMed, Scopus, EMBASE, Virtual Health Library, and Cochrane Library were used to scan for published trials that met the inclusion criteria until January 2019. The qualified studies were subjected to a systematic review and proportional analysis, and the randomised controlled trials (RCTs) were included in a comparison meta-analysis. Results Thirteen studies were included 156 findings. The total number of hips was 2278. Nine studies were cohort, and four were RCTs between ceramic and polyethylene cups. The analysis revealed an average age of 44 years (range 24–54). The 10-year survival 96% (95% CI; 95.4–96.8%), aseptic loosening rate 0.516. (95% CI; 0.265–0.903), ceramic fracture rate 0.620 (95% CI; 0.34–1.034) and squeaking rate 2.687 (95% CI; 1.279–4.593). A comparison meta-analysis revealed the risk ratio (RR) for revision was 0.27 (95% CI; 0.15–0.47), and for aseptic loosening 0.15 (0.03–0.70) favouring CoC, while RR for component fracture was 1.62 (95% CI; 0.27–9.66) favouring the polyethylene. Conclusion In patients under sixty, current CoC THAs are correlated with better 10-year outcomes than before and have high survivorship rates. Level of evidence: Level I.

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Clinical, functional and radiographic outcomes after revision total hip arthroplasty with tapered fluted modular or non-modular stems: a systematic review

Hip International ◽

10.1177/11207000211004383 ◽

2021 ◽

pp. 112070002110043

Author(s):

Antonios A Koutalos ◽

Sokratis Varitimidis ◽

Konstantinos N Malizos ◽

Theofilos Karachalios

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Revision Rate ◽

Clinical Results ◽

Fracture Rate ◽

Revision Total Hip Arthroplasty ◽

Term Survival ◽

Total Hip ◽

Radiographic Outcomes

Purpose: The aim of the study was to systematically evaluate clinical outcomes of tapered fluted stems, either monoblock or modular, in revision total hip arthroplasty. Methods: PubMed, EMBASE and Web of Science and Cochrane databases were systematically searched by 2 researchers. Clinical studies reporting primarily on survival and re-revision rates, and secondarily on subsidence, dislocation, intraoperative fractures, periprosthetic fractures and infection were included. 2 investigators assessed the quality of the studies. Results: 46 studies were included in this review, reporting on 4601 stem revisions. The pooled re-revision rate was 5.1% and long-term survival ranged from 75% to 98.5%. No differences were observed between monoblock and modular stems regarding re-revision rate, dislocation rate, periprosthetic fracture rate or infection rates. Monoblock stems exhibited more subsidence and modular stems displayed more intraoperative fractures. Conclusions: Satisfactory results can be obtained with the use of tapered fluted end-bearing stems. Monoblock stems offer the same clinical results as modular stems.

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Letter to the editor regarding “Ceramic-on-ceramic articulation in press-fit total hip arthroplasty as a potential reason for early failure, what about the survivors: a ten year follow-up” by Loon et al.

International Orthopaedics ◽

10.1007/s00264-021-04996-5 ◽

2021 ◽

Author(s):

Weifeng Ji ◽

Jing Shen

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Early Failure ◽

Total Hip ◽

Press Fit ◽

Potential Reason ◽

Letter To The Editor ◽

Ceramic On Ceramic

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Incidence of low-grade infection in aseptic loosening of total hip arthroplasty

Acta Orthopaedica ◽

10.3109/17453674.2010.525201 ◽

2010 ◽

Vol 81 (6) ◽

pp. 667-673 ◽

Cited By ~ 55

Author(s):

Dirk Jan F Moojen ◽

Gijs van Hellemondt ◽

H Charles Vogely ◽

Bart J Burger ◽

Geert H I M Walenkamp ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Aseptic Loosening ◽

Hip Arthroplasty ◽

Low Grade ◽

Total Hip

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No Association of CALCA Polymorphisms and Aseptic Loosening after Primary Total Hip Arthroplasty

BioMed Research International ◽

10.1155/2018/3687415 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Tünay Aydin-Yüce ◽

Gina Kurscheid ◽

Hagen Sjard Bachmann ◽

Thorsten Gehrke ◽

Marcel Dudda ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Aseptic Loosening ◽

Hip Arthroplasty ◽

Fragment Length Polymorphism ◽

Genotype Distribution ◽

Chain Reaction ◽

Total Hip ◽

Polymerase Chain ◽

European Group ◽

Primary Total Hip Arthroplasty

Studies of aseptic loosening showed an influence of calcitonin andα-CGRP, both encoded from the calcitonin/α-CGRP (CALCA) gene by alternative splicing. The aim of this study was to detect a possible association of the CALCA polymorphisms P1(rs1553005), P2(rs35815751), P3(rs5240), and P4(rs2956) with the time to aseptic loosening after THA. 320 patients suffering from aseptic loosening after primary total hip arthroplasty were genotyped for CALCA-P1 polymorphism and 161 patients for CALCA-P2 and CALCA-P3 polymorphisms and 160 patients for CALCA-P4 polymorphism. CALCA genotypes were determined by polymerase chain reaction and restriction-fragment length polymorphism. The genotype distribution of CALCA-P1 was CC 10%, CT 43%, and 46% TT. CALCA-P2 showed a distribution of 90.7%II, 8.7% ID, and 0.6% DD. The CALCA-P3 genotype distribution was 97.5% TT and 2.5% TC. The CALCA-P4 genotype distribution was 48.1% AA, 40% AT, and 11.9% TT. Significant differences between the CALCA genotypes were not found concerning age at implantation and replantation, BMI, gender, and cementation technique. No associations of the time for aseptic loosening were found. In conclusion, we did not find a significant association of CALCA polymorphisms and the time to aseptic loosening after primary THA in a Western European group.

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