A Mid-Term Analysis Suggests Ceramic on Ceramic Hip Arthroplasty is Durable with Minimal Wear and Low Risk of Squeak

Molloy, Dennis; Jack, C.; Esposito, Christina; Walter, William K.

doi:10.1007/s11420-012-9291-y

Cited by 15 publications

(5 citation statements)

References 21 publications

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“…2,3 Clinical outcomes in the mid to long term for CoC bearings are encouraging, with low rates of revision. 4,5 However, rates of squeaking of between 2% and 21% have been reported. 5,6 Larger diameter fourth generation CoC bearings were introduced to provide more natural biomechanics and increased stability.…”

Section: Resultsmentioning

confidence: 99%

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Functional orientation of the acetabular component in ceramic-on-ceramic total hip arthroplasty and its relevance to squeaking

Pierrepont

Feyen²,

Miles³

et al. 2016

The Bone & Joint Journal

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The functional orientation of the acetabular component during activities associated with posterior edge-loading are different from those measured when supine due to patient-specific pelvic kinematics. Individuals with a large anterior pelvic tilt during deep flexion might be more susceptible to posterior edge-loading and squeaking as a consequence of a significant decrease in the functional anteversion of the acetabular component. Cite this article: Bone Joint J 2016;98-B:910-16.

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Section: Resultsmentioning

confidence: 99%

“…4,5 However, rates of squeaking of between 2% and 21% have been reported. 5,6 Larger diameter fourth generation CoC bearings were introduced to provide more natural biomechanics and increased stability. Nevertheless, rates of squeaking of 12.5% have still been reported with these modern large diameter bearings.…”

Section: Resultsmentioning

confidence: 99%

Functional orientation of the acetabular component in ceramic-on-ceramic total hip arthroplasty and its relevance to squeaking

Pierrepont

Feyen²,

Miles³

et al. 2016

The Bone & Joint Journal

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“…5 However, with the recent problems observed with MoM THA, CoC is now considered to be the safer choice with low rates of wear and excellent survival, which in some studies is greater than that of MoP, at ten years and beyond, even in young, high demand patients. [6][7][8][9] In spite of the low rates of wear of both CoC and MoM bearings, there are theoretical advantages to the use of ceramic-on-metal (CoM) bearings. The use of bearing surfaces with different levels of hardness may result in lower rates of wear.…”

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confidence: 99%

Early surveillance of ceramic-on-metal total hip arthroplasty

Hill

Diamond

O’Brien

et al. 2015

The Bone & Joint Journal

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Ceramic-on-metal (CoM) is a relatively new bearing combination for total hip arthroplasty (THA) with few reported outcomes. A total of 287 CoM THAs were carried out in 271 patients (mean age 55.6 years (20 to 77), 150 THAs in female patients, 137 in male) under the care of a single surgeon between October 2007 and October 2009. With the issues surrounding metal-on-metal bearings the decision was taken to review these patients between March and November 2011, at a mean follow-up of 34 months (23 to 45) and to record pain, outcome scores, radiological analysis and blood ion levels. The mean Oxford Hip Score was 19.2 (12 to 53), 254 patients with 268 hips (95%) had mild/very mild/no pain, the mean angle of inclination of the acetabular component was 44.8(o) (28(o) to 63(o)), 82 stems (29%) had evidence of radiolucent lines of > 1 mm in at least one Gruen zone and the median levels of cobalt and chromium ions in the blood were 0.83 μg/L (0.24 μg/L to 27.56 μg/L) and 0.78 μg/L (0.21 μg/L to 8.84 μg/L), respectively. The five-year survival rate is 96.9% (95% confidence interval 94.7% to 99%). Due to the presence of radiolucent lines and the higher than expected levels of metal ions in the blood, we would not recommend the use of CoM THA without further long-term follow-up. We plan to monitor all these patients regularly.

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“…They describe 9 revisions, not performed for ceramic-related complications, and conclude that the patients in the series had a good implant survival rate, good function and a low implant wear rate. Same sample and same duration of follow-up have been reported by Molloy et al 17 They reviewed a consecutive series of 301 primary cementless 3rd-generation alumina-on-alumina THAs at a minimum of 10 years follow-up (10% of the patients had died of unrelated cause at the latest follow-up) and demonstrated an overall implant survival rate of 98%, no ceramic fractures, no osteolysis and no failures related to bearing wear, although 0.6% of their hips were revised due to squeaking.…”

Section: Discussionmentioning

confidence: 56%

A minimum 20-year outcome of 100 consecutive alumina-on-alumina arthroplasties performed by a single surgeon

et al. 2018

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Background: Ceramic-on-ceramic (CoC) is currently a viable bearing combination in primary total hip arthroplasty (THA) and, due to its mechanical properties, it can be used in young patients requiring a long-lasting implant. The aim of this study is to report the results of a series of CoC THAs at a minimum 20 years follow-up. Methods: A retrospective study was conducted on the 1st 100 consecutive alumina-on-alumina arthroplasties performed by a single surgeon on 51 females and 40 males with an average age of 60.7 years. The mean preoperative Harris Hip Score was 35. The press-fit cup consisted of a pure titanium core with a titanium alloy mesh. Both the inlay and the head were made of dense polycrystalline surgical-grade alumina. The 32-mm femoral head was anchored on 3 different femoral components. Results: 19 patients with 22 THAs were died or lost, 2 anatomic cementless stems were revised due to sinking, 1 THA was revised for periprosthetic infection. 2 patients sustained a Vancouver B1 periprosthetic femoral fracture. None of the 78 THAs eligible for this study were revised for wear, breakage, noise of the ceramic components. None of the cups, none of the cemented stems, none of the cementless straight stems failed. HHS raised up to a mean value of 95. Conclusions: The present report demonstrates that CoC coupling offers minimal wear at a long-term follow-up. Further studies are needed to evaluate whether the modern ceramic composites will confirm such excellent results in total hip replacement.

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A Mid-Term Analysis Suggests Ceramic on Ceramic Hip Arthroplasty is Durable with Minimal Wear and Low Risk of Squeak

Abstract: We believe that ceramic-on-ceramic is a safe bearing coupling with excellent survivorship at 10 years.

Cited by 15 publications

References 21 publications

Functional orientation of the acetabular component in ceramic-on-ceramic total hip arthroplasty and its relevance to squeaking

Functional orientation of the acetabular component in ceramic-on-ceramic total hip arthroplasty and its relevance to squeaking

Early surveillance of ceramic-on-metal total hip arthroplasty

A minimum 20-year outcome of 100 consecutive alumina-on-alumina arthroplasties performed by a single surgeon

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