1. The use of a ceramic "sandwich cup" in 140 hip arthroplasty with a 5 years follow-up or more
M. P. Philippe, J. Hummer, T. Musset, P. Poilbout and C. Schwartz
Introduction
Wear leads to loosening of hip prostheses. It is now well-known that the couple ceramic-ceramic limits wear. The rigidity of the massive ceramic cups and their great volume limit their use. The "sandwich insert" (alumina insert in an ultra-high density polyethylen cup) seems to be an interesting compromise.
Material and Method
Between the 17/03/1999 and the 20/06/2001we operated 140 patients. There were as many men as women, of an average age of 60 years and with an average BMI of 23.5. In 83% of the cases arthritis was concerned. The Merle d’Aubigné score was preoperative of 11.1 points. We used a non-cemented titanium alloy acetabular cup, elastic thanks to a slot, with a low thickness and hydroxyl-apatite coated; it contains a polyethylene cup in which is enchased an alumina insert. (Atlas, FH Orthopedics.) The femoral stem in all the cases was posed without cement too.
Results
All the patients could be re-examined after 5 years or more. Clinically the Merle d’ Aubigné score grew at 17.2. One patient presented dislocations which need surgical treatment. Another presented an infection requiring a new operation too. There was no rupture of the alumina implant in this series. Radiography showed an excellent osseous integration except one. No wear could be measured.
Conclusion
With still a short follow-up for orthopedic surgery of the hip it can be noted that the results are completely satisfactory on the clinical and radiological level; the survival of the sandwich "alumina in polyethylene" implants is similar to the best of the other implants on the market and without complications with regard to his originality.
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