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RANDOMISED TRIAL COMPARING ALUMINA WITH METAL-POLYETHYLENE TOTAL HIP ARTHROPLASTY



Abstract

Introduction: The excellent results obtained with metal-polyethylene (M-P) bearing surfaces in total hip arthroplasty (THA) are still limited by the production of polyethylene wear debris, osteolysis and aseptic loosening. Because of its superior tribologic properties and biologically inert composition, alumina-alumina (AL-AL) bearing surfaces are proposed to improved survival of THA but previously reported early complications prevented widespread use of this material.

Aim: To compare the early results and complications with Ceraver M-P and AL-AL THA.

Methods: One hundred and thirty-eight Ceraver hybrid THAs in patients less than 70 years old were randomised to M-P or AL-AL bearing surfaces. We present the clinical and radiological results for patients followed-up from six to 48 months.

Results: No significant difference was found on W.O.M.A.C. and Merle D’ Aubigné Postel scores. No specific complication associated with alumina components like fracture or malpositioning of the acetabular insert were observed in this study. Documented complications were: infection 3 AL-AL / 0 M-P; dislocation 1 AL-AL / 4 M-P; and heterotopic ossification 47% AL-AL / 24% M-P. No aseptic loosening was observed.

Discussion and Conclusion: Ceraver AL-AL bearing surfaces gave early clinical and radiological results similar to M-P. Our results were in accordance with studies suggesting that AL-AL has the potential to become the bearing surfaces of choice in THA in the young patients.

The abstracts were prepared by Professor A. J. Thurston. Correspondence should be addressed to him at the Department of Surgery, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand