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Similar wear in total hip arthroplasties with metallic or zirconia femoral heads.

ABSTRACT: Ceramic femoral heads have been used in an attempt at reducing polyethylene wear of total hip arthroplasties. Clinical results with zirconia femoral heads have been mixed. This study was undertaken to compare the polyethylene wear and incidence of periprosthetic osteolysis in total hip replacements performed using a 28-mm zirconia versus a 28-mm cobalt chromium femoral head. Thirty-five hips with a 28-mm cobalt chromium head and 68 hips with a 28-mm zirconia head were evaluated after a minimum follow-up of 2 years (average, 4.0 years; range, 2.0 to 9.1 years). A monoblock acetabular component was used in all patients. Polyethylene wear was measured in serial radiographs from 58 of the hips utilizing a computer-assisted vector wear technique. Periacetabular osteolysis developed in three patients (two with a zirconia head and one with a cobalt chromium head). The total wear and the annual wear rate were 0.48 mm and 0.11 mm/year for the cobalt chromium heads and 0.53 mm and 0.14 mm/year for the zirconia heads, respectively. We found no benefit with respect to the rate of polyethylene wear or incidence of osteolysis with the use of zirconia femoral heads.

SUBMITTER: Cohn RM

PROVIDER: S-EPMC2553166 | biostudies-other | 2008 Sep

REPOSITORIES: biostudies-other

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Project description:BackgroundThe introduction of new devices for total hip arthroplasty (THA) offers surgeons the ability to address deficits in the portfolio. However, once introduced, data regarding the performance of devices is not publicly available until their use is widespread.Purpose/questionsThe objective of this study was to compare the clinical and radiographic performance, including patient reported outcomes and radiographic evidence of osseointegration, subsidence, and stress shielding, of the newer Actis femoral component to the Corail stem (DePuy Synthes, Warsaw, IN, USA), which has an extensive clinical history.MethodsThis short-term, retrospective cohort study was a single surgeon series of 330 anterior approach THAs, consisting of 165 cases using the Actis stem and 165 cases using the Corail stem. Both devices were cementless, titanium, tapered, hydroxyapatite-coated stems. They differed in geometry, neck choices, broach philosophy, and collar availability. Data was obtained for 1 year following THA. Functional outcomes were measured with the Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement (HOOS, JR.) survey. Complications were recorded from patient charts, and radiographic analysis was performed for signs of osseointegration, subsidence, and stress shielding.ResultsThe groups shared similar demographic characteristics except the Actis population was younger with fewer women. The complication rate did not significantly vary, and no patient required revision within the first year. Radiographically, one patient in each group demonstrated subsidence. No cases exhibited radiolucent lines, and the prevalence of stress shielding at 1 year was comparable. HOOS, JR. scores did not significantly vary at 8 weeks or 1 year.ConclusionThe Actis stem does not carry an increased risk of device-related complications compared with the Corail implant. Although aspects of bone remodeling differed between groups, Actis achieved radiographic signs of bone ingrowth at the 1-year mark and performed well clinically, with equivalent patient reported outcome scores to the Corail stem.

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Similar wear in total hip arthroplasties with metallic or zirconia femoral heads.

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