36mm Ceramic head for “difficult” cases

Abstract

The heads of big diameter, like Mc Farrar, Ring and Muller, already appeared during the 60's. At that time characterized by a metal-metal coupling, whose sizing generally spared heads from 32mm to 41mm, all the correlated hip joint reconstructions reported quite variable clinical outcomes. At the end of the 80's new advanced tribological featuring allowed their re-birthing. The advantages of a 36mm coupling are well known because of a low risk ratio of dislocation, of an high articular range of motion, of it proprioceptiveness and stability. In our division we are using ceramic heads of 36mm for THA since three years reporting more than 200 cases. At the beginning of our experience the use of this coupling diameter was elected in according to patient age, because we had availability only of the ceramic-ceramic joint replacement. Since we have also had the availability of the cross-linked polyethylene for 36 mm coupling, we could extend the indication to almost the totality of the cases. For our THA we use the Delta Acetabular Cup system by Lima Lto company, which allows such a coupling diameter starting from 50mm acetabular size.