Ceramic Femoral Heads Exhibit Lower Wear Rates Compared to Cobalt Chrome: A Meta-Analysis

Mertz, Kevin; Yang, JaeWon; Chung, Brian; Chen, Xiao; Mayfield, Cory K.; Heckmann, Nathanael

doi:10.1016/j.arth.2022.09.008

Cited by 5 publications

(4 citation statements)

References 68 publications

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“…[ 38 ] Mertz et al reported that fourth-generation ceramic heads were found to have significantly lower wear rates of HXLPE than cobalt-chromium heads in the systematic review, whereas no significant difference was found between the 2 materials in the meta-analysis. [ 39 ] Although it was not clear whether cobalt-chromium heads resulted in increased linear wear, the difference of head materials in 2 groups might have affected the results of polyethylene wear. Lastly, measurement error might have affected the results of polyethylene wear.…”

Section: Discussionmentioning

confidence: 99%

Minimum 7-year results of cementless total hip arthroplasty with vitamin E-diffused and 2-methacryloyloxyethyl phosphorylcholine-grafted highly cross-linked polyethylene

Naito,

Hasegawa,

Tone

et al. 2023

Medicine

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The purpose of this study was to evaluate the mid-term clinical results and polyethylene wear of vitamin E-diffused highly cross-linked polyethylene (HXLPE) and 2-methacryloyloxyethyl phosphorylcholine (MPC)-grafted HXLPE in cementless total hip arthroplasty (THA). Thirty-four THAs with vitamin E-diffused HXLPE (VEPE) and 32-mm cobalt-chromium head, and 116 THAs with MPC-grafted HXLPE and 32-mm alumina head were evaluated. The Merle d’Aubigné and Postel scores were administered. Kaplan–Meier survivorship was analyzed. Annual radiographs were analyzed using computerized method and linear steady-state wear rate was measured. The mean duration of follow-up was 9 years (range, 7–11 years) in VEPE group and 8 years (range, 7–10 years) in MPC group. The mean Merle d’Aubigné and Postel scores improved postoperatively in both groups. Kaplan–Meier survivorship with endpoint of revision was 100% (95% confidence interval, 100%–100%) in VEPE group and 98.3% (95% confidence interval, 93.4%–99.6%) in MPC group at 10 years (P = .44). The mean steady-state wear rate was 0.007 mm/year in VEPE group and 0.006 mm/year in MPC group (P = .60). The clinical results of both groups were good and wear rates of both liners were very low.

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Section: Discussionmentioning

confidence: 99%

Minimum 7-year results of cementless total hip arthroplasty with vitamin E-diffused and 2-methacryloyloxyethyl phosphorylcholine-grafted highly cross-linked polyethylene

Naito,

Hasegawa,

Tone

et al. 2023

Medicine

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“…Pure alumina, zirconia, and zirconia-toughened alumina have been used as ceramic femoral heads. Ceramic femoral heads have harder and smoother surfaces than metal femoral heads and are more resistant to third-body damage; they have better wettability and decreased surface roughness, which can contribute to less polyethylene wear [ 95 ]. A randomized controlled trial with radiostereometric analysis demonstrated that ceramic heads (0.003 mm/year) showed no superiority in HXLPE wear over metal heads (0.007 mm/year) [ 96 ].…”

Section: Effects Of Femoral Head Materials In Tha and Femoral Compone...mentioning

confidence: 99%

“…A systematic review and meta-analysis by Gosling et al [ 97 ] demonstrated no differences in wear rates between ceramic and metal heads. Another systematic review and meta-analysis by Mertz et al [ 95 ] compared the steady-state wear rates of ceramic and metal femoral heads with HXLPE liners. The mean wear rate was significantly higher with metal heads (0.063 mm/year) than with ceramic heads (0.047 mm/year).…”

Section: Effects Of Femoral Head Materials In Tha and Femoral Compone...mentioning

confidence: 99%

“…Using a ceramic femoral component in TKA, excellent clinical results with a minimum of 10-year follow-up period were reported [ 100 ]. The cumulative percent revision was 0.9% at 10 years [ 95 ]. A prospective comparative study of ceramic and metal femoral components in TKA at a more than five-year follow-up revealed that the outcomes of the ceramic femoral component demonstrated good clinical and radiological results, as well as survival comparable to that of the metal femoral component after TKA and failed to show superior results using a ceramic femoral component [ 101 ].…”

Section: Effects Of Femoral Head Materials In Tha and Femoral Compone...mentioning

confidence: 99%

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Ultra-High-Molecular-Weight Polyethylene in Hip and Knee Arthroplasties

et al. 2023

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Ultra-high-molecular-weight polyethylene (UHMWPE) wear and particle-induced osteolysis contribute to the failure of total hip arthroplasty (THA) and total knee arthroplasty (TKA). Highly crosslinked polyethylene (HXLPE) was developed in the late 1990s to reduce wear and has shown lower wear rates and loosening than conventional UHMWPE in THA. The irradiation dose for crosslinking is up to 100 kGy. However, during crosslinking, free radical formation induces oxidation. Using HXLPE in THA, the cumulative revision rate was determined to be significantly lower (6.2%) than that with conventional UHMWPE (11.7%) at a mean follow-up of 16 years, according to the Australian Orthopaedic Association National Joint Replacement Registry. However, HXLPE does not confer to TKA the same advantages it confers to THA. Several alternatives have been developed to prevent the release of free radicals and improve polymer mechanical properties, such as thermal treatment, phospholipid polymer 2-methacryloyloxyethyl phosphorylcholine grafting, remelting, and vitamin E addition. Among these options, vitamin E addition has reported good clinical results and wear resistance similar to that of HXLPE without vitamin E, as shown by short-term clinical studies of THA and TKA. This review aims to provide a comprehensive overview of the development and performance of UHMWPE in THA and TKA.

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Excellent Results of Large-Diameter Ceramic-On-Ceramic Bearings in Total Hip Arthroplasty at Minimum Ten-Year Follow-Up

Beckers,

Morcos,

Lavigne

et al. 2024

The Journal of Arthroplasty

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Ceramic Femoral Heads Exhibit Lower Wear Rates Compared to Cobalt Chrome: A Meta-Analysis

Cited by 5 publications

References 68 publications

Minimum 7-year results of cementless total hip arthroplasty with vitamin E-diffused and 2-methacryloyloxyethyl phosphorylcholine-grafted highly cross-linked polyethylene

Minimum 7-year results of cementless total hip arthroplasty with vitamin E-diffused and 2-methacryloyloxyethyl phosphorylcholine-grafted highly cross-linked polyethylene

Ultra-High-Molecular-Weight Polyethylene in Hip and Knee Arthroplasties

Excellent Results of Large-Diameter Ceramic-On-Ceramic Bearings in Total Hip Arthroplasty at Minimum Ten-Year Follow-Up

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