Use of Modular Femoral Stem combined with large Diameter Femoral Head in Alumina-on-Alumina Total Hip Arthroplasty

  • Youn-Soo Park
  • Y.-W. Moon
  • S.-J. Lim
Conference paper
Part of the Ceramics in Orthopaedics book series (CIO)


While the clinical use of alumina-on-alumina bearings in total hip arthroplasty has demonstrated excellent clinical results with a low rate of osteolysis, relatively few head and liner options of alumina implants compared with conventional metal-on-polyethylene articulations continue to be one potential disadvantage that may often lead to impingement or dislocation after total hip arthroplasty. We hypothesized that a modular femoral stem that offered a variety of intraoperative adjustment options for producing appropriate femoral offset, length, and version would be favored to optimize stability following alumina-on-alumina total hip arthroplasty. It was also postulated that larger diameter femoral heads that allow for a greater range of motion prior to prosthetic impingement could reduce the risk of dislocation following alumina-on-alumina total hip arthroplasty. When reviewing a consecutive series of 136 alumina-on-alumina total hip arthroplasties performed with use of the S-ROM modular stem combined with 32-mm femoral head at our institution, we have found no ceramic fractures or bearing failures, and only one early postoperative dislocation that resolved with closed reduction was identified during the short follow-up period. Given the extremely low wear rates of alumina-on-alumina bearings even with larger femoral head diameters, our findings may increase potential for use of 32-mm femoral head combined with the S-ROM modular stem in both straightforward and complex total hip arthroplasties that are at high risk for prosthetic impingement or dislocation.


Femoral Head Acetabular Liner Large Femoral Head Ceramic Femoral Head Modular Stem 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Willmann G. Ceramic femoral head retrieval data. Clin Orthop Relat Res. 2000; 379:22–28.PubMedCrossRefGoogle Scholar
  2. 2.
    Nizard R, Sedel L, Hannouche D, Hamadouche M, Bizot P. Alumina pairing in total hip replacement. J Bone Joint Surg Br. 2005; 87:755–758.PubMedCrossRefGoogle Scholar
  3. 3.
    Bizot P, Hannouche D, Nizard R, Witvoet J, Sedel L. Hybrid alumina total hip arthroplasty using a press-fit metal backed socket in patients younger than 55 years: a six-to 11-year evaluation. J Bone Joint Surg Br. 2004; 86:190–194.PubMedCrossRefGoogle Scholar
  4. 4.
    Yoo JJ, Kim YM, Yoon KS, Koo KH, Song WS, Kim HJ. Alumina-on-alumina total hip arthroplasty. A five-year minimum follow-up study. J Bone Joint Surg Am. 2005; 87:530–535.PubMedCrossRefGoogle Scholar
  5. 5.
    D’Antonio J, Capello W, Manley M, Naughton M, Sutton K. Alumina ceramic bearings for total hip arthroplasty: five-year results of a prospective randomized study. Clin Orthop Relat Res. 2005; 436:164–171.PubMedCrossRefGoogle Scholar
  6. 6.
    Barrack RL, Burak C, Skinner HB. Concerns about ceramics in THA. Clin Orthop Relat Res. 2004; 429:73–79.PubMedCrossRefGoogle Scholar
  7. 7.
    Shon WY, Baldini T, Peterson MG, Wright TM, Salvati EA. Impingement in total hip arthroplasty: a study of retrieved acetabular components. J Arthroplasty. 2005; 20:427–435.PubMedCrossRefGoogle Scholar
  8. 8.
    Hasegawa M, Sudo A, Uchida A. Alumina ceramic-on-ceramic total hip replacement with a layered acetabular component. J Bone Joint Surg Br.2006; 88:877–882.PubMedCrossRefGoogle Scholar
  9. 9.
    Park YS, Hwang SK, Choy WK, Kim YS, Moon YW, Lim SJ. Ceramic failure after total hip arthroplasty with an alumina-on-alumina bearing. J Bone Joint Surg Am. 2006; 88:780–787.PubMedCrossRefGoogle Scholar
  10. 10.
    Fisher J, Jin Z, Tipper J, Stone M, Ingham E. Tribology of alternative bearings. Orthop Relat Res. 2006; 453:25–34.CrossRefGoogle Scholar

Copyright information

© Steinkopff Verlag 2007

Authors and Affiliations

  • Youn-Soo Park
    • 1
  • Y.-W. Moon
  • S.-J. Lim
  1. 1.Department of Orthopedic SurgerySamsung Medical CenterSeoulKorea

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