Ceramic hip prostheses in young patients: a retrospective study of 74 patients.

Zones of osteolysis occur in mobilized and in well-fixed prostheses with the classic ultrahigh molecular weight polyethylene-metal couple. However, since 1981 with the use of the ceramic couple in cemented hip prostheses in young patients, osteolysis has not been observed. The prostheses in patients with a longer followup do not show signs of wear in the bearing or signs of bone lysis in the well-fixed prostheses. Cementless prostheses with the same type of ceramic bearing have been used since 1990 in patients with more than 30 years of life expectancy, in an effort to eliminate loosening at the cement-bone interface. The cementless prostheses performed well with spot welds visible 3 months after the operation, which still are present at 7 years of followup. Lysis has not been observed behind the cup or around the stem. In the current series, head ruptures and accidents in the stem and neck junction produced by the modularity of the prostheses did not occur. The authors focus on the positive results shown by ceramic bearings and describe the results of 31 cemented, five hybrid, and 58 uncemented prostheses with ceramic bearings in patients younger than 50 years of age.