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

Research output: Contribution to journalJournal articleResearchpeer-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.

Original languageEnglish
Article number35
JournalJournal of orthopaedic surgery and research
Issue number1
Pages (from-to)1-9
Number of pages9
Publication statusPublished - 9 Jan 2021

Bibliographical note

Publisher Copyright:
© 2021, The Author(s).

Copyright 2020 Elsevier B.V., All rights reserved.

    Research areas

  • Bearing, Ceramic-on-ceramic (CoC), Complications, Delta ceramic, Modified Harris hip score (mHHS), Outcomes, R3 (TM) delta Ceramic Acetabular System, Total hip arthroplasty (THA), UCLA Activity Rating Scale (UCLA ARS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC (R)), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC®), R3™ delta Ceramic Acetabular System

ID: 61730710