Osteoarthritis, Hip Clinical Trial
Official title:
Is Ceramic-on-Ceramic THA Superior to Ceramic-on-Highly Cross-Linked Polyethylene THA in Patients Less Than 55 Years Old?
Methods to reduce the revision rate of total hip arthroplasties (THAs) because of wear-related issues are important to examine, particularly because younger patients have a disproportionately high risk of revision. The investigators hoped to follow up patients and see if long-term Harris hip scores and WOMAC scores better in younger patients with a ceramic-on-ceramic (COC) THA compared with those with a ceramic-on-highly-cross-linked polyethylene (COP) THA.
High success rates obtained in the general population have stimulated for total hip
arthroplasty (THA) in young and active patients. Although there have been substantial
improvements in THA, bearing surface wear and osteolysis are major factors limiting the
durability of THAs in young and active patients. During the last decade, alternative bearings
have been developed, including highly cross-linked polyethylene (HXLPE) and
ceramic-on-ceramic (COC) bearings, with the potential to reduce wear and osteolysis in
younger, more active patients.
Despite contemporary cementless THA with COC bearings giving excellent clinical and
radiographic outcomes, there is concern about squeaking, fracture of the ceramic head or
acetabular insert or fretting and corrosion (trunnionosis). Although HXLPE have been reported
to reduce polyethylene wear, there is concerned about a potential decrease in toughness,
tensile strength and resistance to the propagation of fatigue cracks in a long-term
follow-up.
Several noncomparative studies of COC and COP THA have reported promising results in terms of
Harris hip scores, radiographic findings, and survival rates, yet we are aware of no
long-term comparative clinical studies with a COC THA and a COP THA in the same younger
patients. This study aimed to see if long-term Harris hip scores and Western Ontario and
McMaster Universities Osteoarthritis (WOMAC) score better in younger patients with a COC THA
compared with those with a COP THA.
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