Abstract：
BACKGROUND: This study reports the minimum 10 years results of total hip arthroplasty (THA) performed using a monoblock acetabular component with a large-diameter head ceramic-on-ceramic bearing.
METHODS: Of the 276 THAs included in this study, there were eleven deaths and 27 patients lost to follow up (11%) during the follow-up, leaving 237 (85%) hips available for review at a mean of 10.5 years (range, 10 to 12) postoperatively. Reoperations, implant revisions, adverse events, clinical outcomes, radiographic evaluation, and whole blood metal ion levels were assessed at the last follow-up.
RESULTS: After a minimum of 10 years, implant survivorship was 98.7%. There were 3 revisions (1.3%): one for insufficient acetabular cup primary fixation, one traumatic periprosthetic acetabular fracture, and one probable deep chronic infection. No dislocation or ceramic implant fracture was observed. The mean University of California at Los Angeles activity score, Western Ontario and McMaster Universities Osteoarthritis Index score, and Forgotten Joint Score were 5.6 (2 to 10), 90.1 (9 to 100), and 79.2 (4 to 100), respectively. All patients (100%) were satisfied or very satisfied. Since implantation, 43% of patients reported hearing a squeaking noise from the prosthesis. But all patients who reported squeaking were satisfied with the surgery. The mean titanium level was 2.2 μg/L (1.1 to 5.6). No progressive radiolucent lines, osteolysis, or implant loosening signs were observed at the last radiographic evaluation.
CONCLUSIONS: A large-diameter head ceramic-on-ceramic THA provides outstanding long-term (minimum 10 years) implant survivorship with unrestricted activity while avoiding implant impingement, liner fracture, and hip instability. Functional outcomes, satisfaction, and joint perception were excellent. Although the incidence of squeaking was high, it did not affect patient satisfaction or function. The systemic titanium levels were low, related to unavoidable passive corrosion of implant surfaces, and did not reveal any indirect signs of trunnionosis.
METHODS: Of the 276 THAs included in this study, there were eleven deaths and 27 patients lost to follow up (11%) during the follow-up, leaving 237 (85%) hips available for review at a mean of 10.5 years (range, 10 to 12) postoperatively. Reoperations, implant revisions, adverse events, clinical outcomes, radiographic evaluation, and whole blood metal ion levels were assessed at the last follow-up.
RESULTS: After a minimum of 10 years, implant survivorship was 98.7%. There were 3 revisions (1.3%): one for insufficient acetabular cup primary fixation, one traumatic periprosthetic acetabular fracture, and one probable deep chronic infection. No dislocation or ceramic implant fracture was observed. The mean University of California at Los Angeles activity score, Western Ontario and McMaster Universities Osteoarthritis Index score, and Forgotten Joint Score were 5.6 (2 to 10), 90.1 (9 to 100), and 79.2 (4 to 100), respectively. All patients (100%) were satisfied or very satisfied. Since implantation, 43% of patients reported hearing a squeaking noise from the prosthesis. But all patients who reported squeaking were satisfied with the surgery. The mean titanium level was 2.2 μg/L (1.1 to 5.6). No progressive radiolucent lines, osteolysis, or implant loosening signs were observed at the last radiographic evaluation.
CONCLUSIONS: A large-diameter head ceramic-on-ceramic THA provides outstanding long-term (minimum 10 years) implant survivorship with unrestricted activity while avoiding implant impingement, liner fracture, and hip instability. Functional outcomes, satisfaction, and joint perception were excellent. Although the incidence of squeaking was high, it did not affect patient satisfaction or function. The systemic titanium levels were low, related to unavoidable passive corrosion of implant surfaces, and did not reveal any indirect signs of trunnionosis.
摘要：
目的：本研究报告了使用具有大直径头部（LDH）陶瓷对陶瓷（CoC）轴承的整体髋臼组件进行全髋关节置换术（THA）的至少10年结果。
方法：在本研究中包含的276个THA中，237(85%)可供审查，平均10.5年(范围，10至12）术后。随访期间有11人死亡。再操作,植入物修正,不良事件,临床结果，射线照相评估，在最后一次随访时评估全血金属离子水平。
结果：至少10年后，植入物存活率为98.7%。有三个修正（1.3％）：一个用于髋臼杯主要固定不足，1例创伤性假体周围髋臼骨折,和一个可能的深部慢性感染。未观察到脱位或陶瓷植入物断裂。加州大学洛杉矶分校(UCLA)的平均活动分数，西安大略省和麦克马斯特大学骨关节炎指数评分，被遗忘的联合得分为5.6分（2比10），90.1（9到100），和79.2（4到100），分别。在植入后的10年里，至少43%的患者报告听到假体发出吱吱声。所有臀部吱吱作响的患者都对手术感到满意。平均钛水平为2.2μg/L（1.1至5.6）。没有渐进的射线可透线，骨质溶解,或在最后一次影像学评估中观察到植入物松动迹象。
结论：LDHCoCTHA提供了出色的长期（至少10年）植入物存活，活动不受限制，同时避免了植入物撞击，衬垫断裂,和髋关节不稳定。功能成果，满意,和联合感知非常好。尽管吱吱声的发生率很高，并不影响患者满意度或功能.全身钛水平很低，与植入物表面不可避免的被动腐蚀有关，也没有发现任何间接的头颅肌病征象.
方法：在本研究中包含的276个THA中，237(85%)可供审查，平均10.5年(范围，10至12）术后。随访期间有11人死亡。再操作,植入物修正,不良事件,临床结果，射线照相评估，在最后一次随访时评估全血金属离子水平。
结果：至少10年后，植入物存活率为98.7%。有三个修正（1.3％）：一个用于髋臼杯主要固定不足，1例创伤性假体周围髋臼骨折,和一个可能的深部慢性感染。未观察到脱位或陶瓷植入物断裂。加州大学洛杉矶分校(UCLA)的平均活动分数，西安大略省和麦克马斯特大学骨关节炎指数评分，被遗忘的联合得分为5.6分（2比10），90.1（9到100），和79.2（4到100），分别。在植入后的10年里，至少43%的患者报告听到假体发出吱吱声。所有臀部吱吱作响的患者都对手术感到满意。平均钛水平为2.2μg/L（1.1至5.6）。没有渐进的射线可透线，骨质溶解,或在最后一次影像学评估中观察到植入物松动迹象。
结论：LDHCoCTHA提供了出色的长期（至少10年）植入物存活，活动不受限制，同时避免了植入物撞击，衬垫断裂,和髋关节不稳定。功能成果，满意,和联合感知非常好。尽管吱吱声的发生率很高，并不影响患者满意度或功能.全身钛水平很低，与植入物表面不可避免的被动腐蚀有关，也没有发现任何间接的头颅肌病征象.
