%0 Journal Article
%@ 1471-2474
%A Beckmann, Nicholas A.
%A Gotterbarm, Tobias
%A Innmann, Moritz M.
%A Merle, Christian
%A Bruckner, Thomas
%A Kretzer, Jan Philippe
%A Streit, Marcus R.
%C London
%D 2015
%F heidok:19443
%I BioMed Central
%J BMC musculoskeletal disorders
%N 249
%P 1-7
%T Long-term durability of alumina ceramic heads in THA
%U https://archiv.ub.uni-heidelberg.de/volltextserver/19443/
%V 16
%X Background: The optimal type of bearing for hip arthroplasty remains a matter of debate. Ceramic-on-polyethylene (CoP) bearings are frequently used in younger and more active patients to reduce wear and increase biocompatibility compared to Metal-on-Polyethylene (MoP) bearings. However, in comparison to metal heads, the fracture risk of ceramic heads is higher. In addition, ceramic head fractures pose a serious complication which often necessitates major revision surgery. To date, there are no long-term data (>20 years of follow-up) reporting fracture rates of the ceramic femoral heads in CoP bearings. The purpose of this research was to investigate long-term CoP fracture rate.   Methods: We evaluated the clinical and radiographic results of 348 cementless THAs treated with 2nd generation Biolox® Al2O3 Ceramic-on-Polyethylene (CoP) bearings consecutively implanted between January 1985 and December 1989. The mean age at implantation was 57 years. The patients were followed for a minimum of 20 years. At the final 111 had died, and 5 were lost to follow-up. The cumulative incidence of ceramic head fractures in the long-term was estimated using a competing risk analysis.   Results: The cumulative incidence of ceramic head fracture after 22-years was estimated with a competing risk analysis at 0.29% after 22-years (SE = 2.09%; 95% - CI: 0.03-1.5%). The radiographic analysis revealed no impending failures at final follow-up.   Discussion/Conclusion: The fracture rate of second-generation ceramic heads using a CoP articulation remains very low into the third decade after cementless THA.