%0 Journal Article
%T Restoring Natural Hip Movements with Large Head (Ceramic on Ceramic) Total Hip Replacement: Experience of Our 150 Patients over 6 Years
%A Sanjay Agarwala
%A Mayank Vijayvargiya
%A Sameer Chaudhari
%J Open Journal of Orthopedics
%P 414-427
%@ 2164-3016
%D 2017
%I Scientific Research Publishing
%R 10.4236/ojo.2017.712044
%X <b>Background: </b>Asian cultures require floor-seated positions demanding a high range of motion
(ROM). Ceramic-On-Ceramic (COC) interface allowed the use of larger head with reduced
wear debris generation and adverse tissue reactions. This study was conducted to
analyze 6-year clinical-radiological outcome with large head fourth generation DeltaMotion<sup><span style=\"white-space:nowrap;\">&amp;reg;</span></sup> ceramic-on-ceramic (COC) hip articulation, with special
emphasis on postoperative ROM, ability to sit cross-legged, stability, hip noise
and revision surgery. <b>Material and Methods: </b>150 consecutive hips were operated
for primary cementless Total Hip Replacement (THR) using DeltaMotion<sup><span style=\"white-space:nowrap;\">&amp;reg;</span></sup> at a tertiary care center in Mumbai, India, between
January 2010 and January 2015. Clinico-radiological outcome was assessed using the
Harris Hip Score (HHS) and radiographs at 6 weeks, 6 months, and annually thereafter. <b>Results: </b>108 (74.5%) patients were males and 37 (25.5%) were females with
an average age of 50.87 years. Mean follow-up was 54
months (range: 37 - 86 months).
The mean ROM was 120¡ã in flexion, 10¡ã in extension, 30¡ã in adduction, 45¡ã in abduction,
25¡ã in internal rotation and 25¡ã in external rotation. The mean HHS showed a statistically
significant improvement of 64.5% (from 54.66 ¡À 6.42 pre-operatively to 89.95 ¡À 4.32
post operatively) (p-value: 0.001). 92% of patients were able to sit in squatting
position and 92% were able to sit cross-legged on the floor at last follow-up. 0.7% joints (1 hip) had squeaking. Considering no
revision surgery as the end point, 6-year prosthesis survivorship was 100%. Complications
(superficial infection) occurred in three hips (2%). All patients reported to be satisfied with their outcome after surgery. <b>Conclusion: </b>We infer that DeltaMotion large head COC bearing allows scope for using larger
head size in relatively smaller Indian hips due to factory fitted ceramic lining.
At 6-year follow-up, high activity level was observed with excellent clinical-radiological
outcomes and component longevity in relatively young Indian population.
%K Ceramic-on-Ceramic
%K Total Hip Arthroplasty
%K Squeaking
%K Prosthesis Survivorship
%K Harris Hip Score
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=80859