Anatomic Cementless Total Hip Arthroplasty with Ceramic Bearings and Modular Necks: 3 to 5 Years Follow-Up

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Abstract
The authors reviewed 216 anatomic cementless hip arthroplasties with ceramic bearings and modular necks, followed up for a minimum of 3 years (range 3–5 years), consecutively implanted in 208 patients between June 1995 and December 1997. The titanium femoral component, proximally hydroxyapatite coated, has 5 different types of prosthetic neck each available in 2 different lengths and is usually articulated with a ceramic on ceramic coupling with a hydroxyapatite coated hemispheric cup. The Mèrle d'Aubigné-Charnley hip score and the Gruen radiographic analysis were used for the clinical and radiological evaluation. Apart from one revision of both cup and stem for a loose implant after 2 years, no osteolysis was noted in the periprosthetic bone, where 99.4% of the prostheses showed good osseointegration. The survival analysis predicted 98.6% good results at 5 years, where survival analysis was performed for all the parts of the prosthesis. The advantage of this prosthesis is the possibility of adaptation to different diaphyseal and extradiaphyseal anatomical conditions. With regard to the neck modularity, for primary arthritis a straight neck was chosen for 81% of the cases, for congenital dysplasia of the hip, a neck with a retroversion of 8°or 15° was used in 34% and a straight neck in 59% of the cases.