الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Total hip arthroplasty (THA) is one of the most successful orthopedic procedures for restoring function and relieving pain in patients with end-stage arthritis of the hip. Implant longevity and THA success depend not only on surgical technique but also on implant design, metallic alloy and type of femoral fixation. The improved techniques and outcomes of THA perhaps accounts for why this procedure is used more often in younger patients with end-stage arthritis. Ceramic on ceramic THA has clearly become the preferred method for younger and high demand patients and might be also be preferred in older patients. This is a retrospective study for evaluation of short term clinical and radiological results of ceramic on ceramic THA in patients with degenerative hip disease. The study was designed too asses functional outcome, early complication and not the longevity of the reconstruction. All patients were reviewed clinically by HHS and radiologically post-operatively. The functional and radiological results were analyzed. In this study, 77 Total hip arthroplasty in 70 patients were performed in Mansoura university Hospital. There were 50 males and 20 females. The average age was 36 (range 19-68 years), the average duration of follow-up was 43 months (range12- 60 months), the majority of cases were primary osteoarthritis (50 hips,65%) while avascular necrosis accounts for 12 hips (15.5%), rheumatoid arthritis 8 hips (10.3%), post traumatic arthritis for 4 hips (5%), S.L. E 1 hips (1.2%), ankylosing spondylitis 2 hips (2.5%). All patients had ceramic on ceramic THA during the study period. There was a significant improvement in the functional outcome scores (Harris Hip Score), There was also improvement in patient activity level, this improvement is proved to be statically significant. The patients were satisfied by the results of surgery and regained their near normal activity level. Two cases were complicated by DVT after the 1st week postoperatively. None of them was complicated by pulmonary embolism. One case developed superficial infection, other case had inflamed wound. Fixation by bone ingrowth was shown radiologically in 70 hips (90.9%), seven (9.09%) showed stable fibrous ingrowth. None of the stems were loose. Stress shielding was observed in 11 hips (14.2%). Heterotopic ossification was seen in 6 hips. Cortical hypertrophy was seen in 16 hips (20.77%), spot welding in 7 hips (9.09%), a halo in 2(2.5%), pedestal in 1 (1. 2%). Although there is some limitation in our study, our results showed marked improvement in clinical and radiographic results of ceramic on ceramic THA as being nowadays performed for younger and more active patients. In the terms of implant survival as measured by revision rate, mortality or the complication rate, Ceramic on ceramic THA has gained very high success rate. Radiographic results were variable and do not seem to correlate with clinical findings. It is almost certain that better short term clinical outcomes mainly improved pain score can be obtained from ceramic on ceramic THA. Overall, the clinical and radiological findings of Ceramic on ceramic THA are satisfactory. This study demonstrates that ceramic on ceramic THA can be successful in reducing pain and improving function, evident to be satisfactory and encouraging during short term follow-up.