A prospective study of functional and clinical outcome of total hip arthroplasty with ceramic on ceramic bearing surfaces
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 2, Pages 1928-1940
AbstractThe incidence of chronic disabling conditions of the hip including osteoarthritis, inflammatory arthritis and osteonecrosis is on the rise. Total hip arthroplasty (THA) is one of the most common surgical procedures performed in these conditions. The increasing number of young and active patients is requiring long lasting and reliable primary hip arthroplasty (THA). Ceramic on ceramic (COC) hip articulations made from alumina have become an attractive option for young and active patients who require THA. The reports suggesting the study of clinical and functional outcome of ceramic on ceramic bearing surfaces are scant in this part of the country. Hence it was decided to take up this study with the aim of studying the clinical and functional outcome of ceramic on ceramic bearing surfaces.
Objectives: To study and compare the clinical and functional outcome of ceramic on ceramic bearing surfaces total hip arthropalsty in a group of patients.
Methodology: A prospective comparative study was undertaken in the Department of orthopaedics of GS Kulkarni Hospital, Miraj. A total of 30 patients undergoing THA with ceramic on ceramic bearing surface were included as study sample and same number of patients with other bearing surface implants was included as controls. The clinical and functional outcomes were evaluated by Modified Harris Hip Score. The radiological assessment included positioning and alignment of the acetabular and femoral components and complications such as periprosthetic fractures, loosening, osteolysis, dislocation, subsidence and heterotrophic ossification.
Results: In our study, both study groups COC and other implants group were statistically comparable for demographical parameters. The stem size, head size, offset, shell size and the liner size were comparable in both study groups. The difference between mean pre operative score and mean post operative was statistically significant in both study groups in various categories such as pain, gait, functional activity, absence of deformity and ROM scores. The acetabular angle and the coverage were not statistically significant between study groups. However the femoral varus deformity was present in 13.3% of the patents in ceramic on ceramic surface group of patients and 36.7% of the other implant cases which was statistically significant between the two groups. Superficial infection was the common complication in both the groups. One patient in ceramic on ceramic surface group had Anterior thigh pain (ATP). About 6.7% of the patients in other type of implant group had ATP and osteolysis. one patient had nerve injury in other implants group.
Conclusion: This study was mainly undertaken to compare the efficacy of the ceramic on ceramic surface with the other type of implants. This study had reported that, majority of the patients with COC were between 41 – 50 years, majority of male gender and AVN was the main indication for the surgery. In both study groups the pain scores, functional gait score, function activity scores, absence of deformity scores, ROM scores, total scores and acetabular angle were significantly different before and after surgery. But there was no statistically significant difference after surgery between the ceramic on ceramic and other type of implant groups except for femoral varus deformity. But this study is not without limitations. The sample size is not large enough to generalize the study results. But this study was able to bring out many facts about the use of ceramic on ceramic implants. Further research with elegant methodology can bring out many facts about the disease.
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