Clinical Results of NCU Ceramic Total Knee Arthroplasty

During the period from 1989 to 1993, Nagoya City University (NCU) ceramic total knee arthroplasty was performed in 89 knees of 60 patients and followed-up for more than 1 year. The diagnoses were osteoarthritis in 50 knees and rheumatoid arthritis in 39 knees. Overall clinical results were almost the same as those of metal components. Although not extremely important clinically, a radiological subsidence of components of more than 1 mm was observed in 3 tibial components and one patellar component out of nine cementless knees. In recent studies, bone ingrowth around alumina ceramic implants was considered to be quite similar to that of metal implants. For this reason, cement use is recommended for the fixation of ceramic implants. Complications associated with ceramic implants were observed in two knees. One was the intraoperative breakage of a tibial tray and the other was a postoperative breakage of a tibial tray without trauma. After the experience of these complications, which may be characteristic of ceramics, we concluded that alumina ceramics were not an appropriate material for the tibial tray and decided to change the material to titanium alloy.