In total hip prosthesis (THP), we have been using alumina ceramic femoral heads to reduce
polyethylene debris and the modified cementing technique, which was named “interface bioactive
bone cement (IBBC)” method to improve implant fixation. In this study, we investigated the
long-term clinical performance of THPs with an alumina ceramic head and IBBC method. From 1986
to 1988, 285 joints (215 patients) were operated on by a senior surgeon, and 265 joints (192 patients)
could be followed up. The presence of radiolucent lines, loosening, osteolysis and
ultrahigh-molecular-weight polyethylene (UHMWPE) socket wear were observed. In IBBC, a
radiolucent line appeared as a ’space’, and loosening appeared as a ’separation’ between the HA layer
and the cement. A ‘space’ appeared in 3 joints (1.4%) on the acetabulum and in 4 joints (1.8%) on the
femur, while a ‘separation’ appeared in 3 joints (1.4%) on the acetabulum. Osteolysis was noted in 1
joint (0.5%) on the acetabulum and in 2 joints (0.9%) on the femur. No revision surgery was required.
In our previous study, we reported that the thickness of the socket affected its clinical wear rate and
that the wear rate of sockets with an alumina ceramic head was 20% lower than that of sockets with a
metal head. By reducing wear debris through the use of ceramic heads, osteolysis could be reduced.
Long-term fixation of THPs to the bone has been achieved by using IBBC. Thus, the long-term
clinical results of THPs with an alumina head that were fixed using IBBC were excellent.
