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Mid-term outcomes of the R3™ delta ceramic acetabular system in total hip arthroplasty

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review


  • Edward T Davis
  • Ville Remes
  • Petri Virolainen
  • Peter Gebuhr
  • Bart Van Backlé
  • Matthew P Revell
  • Branko Kopjar
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BACKGROUND: Whilst bony fixation of hip replacement has stable solutions, there remains controversy over which bearing best optimizes longevity and function. Ceramic-on-ceramic (CoC) bearing combinations are associated with lower risk of revision due to aseptic loosening and dislocation. Evidence for long-term functional outcomes of modern, 4th generation CoC bearings is limited. The aim of this study was to analyze outcomes and complications of the R3™ Acetabular System (Smith & Nephew, Inc., Cordova, TN, USA) in combination with BIOLOX® Delta ceramic femoral head in patients undergoing primary total hip arthroplasty (THA).

METHODS: Between June 2009 and May 2011, 175 patients (178 hips) were enrolled into a prospective, study at 6 sites in Europe and prospectively followed-up at 3 months and 1, 3, 5, and 7 years postoperative.

RESULTS: Total WOMAC score improved from 63 (range, 22-91) preoperative to 8 (range, 0-8) at 1-year follow-up and remained unchanged at 7-year follow-up. Modified Harris hip score improved from 45 (range, 10-87) preoperative to 83 (range, 25-100) at 3 months, 91 (range, 42-100) at 1 year, and 92 (range, 46, 100) at 7 years. UCLA Activity Rating Scale score improved from 3.3 (range, 1-8) preoperative to 6.2 (range, 2-8) at 1 year; it marginally declined to 5.8 (range, 3-8) at 7-year follow-up. There were 4 trochanteric fractures and 5 patients died of unrelated reasons. Three hips were revised (2 periprosthetic fractures and 1 subluxation). The 7-year cumulative survival rate was 98.3%.

CONCLUSION: Clinical and functional improvements of THA with CoC bearing are maintained at 7 years postoperative.

TRIAL REGISTRATION: ClinicalTrials.Gov, NCT03566082 , Registered 10 January 2018-retrospectively registered.

TidsskriftJournal of orthopaedic surgery and research
Udgave nummer1
Sider (fra-til)35
StatusUdgivet - 9 jan. 2021

Bibliografisk note

Funding Information:
The authors wish to thank the following surgeons for their contribution to this study: Lucien CM Keijser, MD, PhD Northwest Clinics Alkmaar Noordwest Ziekenhuisgroep Department of Orthopaedic Surgery Wilhelminalaan 12 1815 JD Alkmaar, The Netherlands Pablo Diaz-Freire, MD Orthopaedic Surgeon, Hip Unit Department of Orthopaedic Surgery and Traumatology Hospital Universitario La Paz Madrid, Spain Enrique Gil-Garay, MD, PhD Professor of Orthopaedic Surgery, Facultad de Medicina Universidad Aut?noma de Madrid Department of Orthopaedic Surgery and Traumatology Hospital Universitario La Paz Madrid, Spain As well as Karen K. Anderson, Nor Consult, LLC for providing medical writing and editing services.

Funding Information:
The study was funded by Smith & Nephew, Inc.

ID: 61730710