• Seung-Jae Lim, Hyung-Gon Ryu, Hyeon-Jun Eun, Chan-Woo Park, Kyeu-Back Kwon, and Youn-Soo Park.
• Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
• J Arthroplasty. 2018 Jul 1; 33 (7): 2182-2186.e1.

BackgroundThe purpose of this study is to evaluate the minimum 5-year outcomes and bearing-specific complications in a single surgeon series of fourth-generation alumina ceramic-on-ceramic total hip arthroplasties (THAs).MethodsWe retrospectively analyzed 667 patients (749 hips) who underwent primary THAs by a single surgeon using fourth-generation alumina ceramic bearings. There were 315 men and 352 women with a mean age of 54.2 years. The surgeon used cementless prostheses with an identical design and BIOLOX Delta ceramics in all hips, using a 36-mm head in 472 hips (63%) and a 32-mm head in 227. The mean follow-up duration was 6.5 years (range, 5 to 8 years).ResultsThe mean Harris hip score improved from 45.6 points preoperatively to 91.3 points at final follow-up. All but 1 acetabular cup and all femoral stems were well fixed. No radiographic evidence of osteolysis was identified at final follow-up. There were 2 (0.3%) ceramic liner fractures and no ceramic head fractures. A total of 48 hips (6.4%) exhibited audible noise (29 clickings and 19 squeakings), but no patient required revision. Other complications were 1 dislocation, 1 deep infection, 3 iliopsoas tendonitis, and 6 periprosthetic femoral fractures. Kaplan-Meier survivorship for revision for any reason was 98.6% (95% confidence interval, 97.7-99.5) at 6.5 years.ConclusionDelta ceramic-on-ceramic THAs had a high rate of survivorship without radiographic evidence of osteolysis at 6.5-year follow-up. However, we found 0.3% ceramic liner fractures and 6.4% audible noises associated with the use of Delta ceramics.Copyright © 2018 Elsevier Inc. All rights reserved.

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