Comparison of Ceramic-on-Ceramic vs. Ceramic-on-Polyethylene for Primary Total Hip Arthroplasty: A Meta-Analysis of 15 Randomized Trials

Abstract

Objective: This meta-analysis aimed to compare ceramic-on-ceramic (COC) components and ceramic-on-polyethylene (COP) components during total hip arthroplasty (THA).Settings: A meta-analysis of randomized controlled trials (RCTs) comparing COC and COP during primary THA was conducted. Electronic searches were current to March 2021.Participants: Trials were included for meta-analysis if they compared at least the bearing surfaces of COC and COP for patients undergoing primary THA and if they reported the outcomes of THA after a certain period of follow-up and only RCTs in English were included.Primary and Secondary Outcome Measures: The primary endpoints consist of audible noise, prosthesis fracture, and revision. Secondary endpoints include dislocation, deep infection, osteolysis, and prosthesis loosening. Extracted data were statistically analyzed with the Stata11.0.Results: A total of 15 RCTs containing 2,702 patients (2,813 hips) were included in this study. The audible noise [odds ratio (OR) = 5.919; 95% CI: 2.043, 17.146; p ≤ 0.001] and prosthesis fracture (OR = 35.768; 95% CI: 8.957, 142.836; p = 0.001) were significantly higher in the COC group. Hip function, revision rate, dislocation rate, deep infection rate, osteolysis rate, and prosthesis loosening rate were comparable between these two groups, while the wear rate was higher in the COP group.Conclusion: This study indicated comparable outcomes of COC and COP bearing surfaces in primary THA; high-quality RCTs with a long-term follow-up are still urgently needed to provide more evidence on the optimal bearing surfaces in primary THA.

May the 4th be with you: mixed-methods best-evidence synthesis on 4th-generation alumina–zirconia ceramic bearings in total hip arthroplasty

“…Infection was studied by 15 experimental and observational studies ( 38 , 39 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 ) enrolled in previous meta-analyses. ( 77 , 78 ) Raw cumulative infection rates were 97/17 633 (0.55%, 95% CI: 0.45–0.67%) with CoC, 1351/158 341 (0.85%, 95% CI: 0.81–0.90%) with MoP, and 6/811 (0.74%, 95% CI: 0.27–1.60%) with CoP. Estimates from random-effects meta-analysis of proportions were 0.44% (95% CI: 0.10–0.93%), 0.59% (0.26–1.01%), and 0.21% (0.00–1.04%), respectively.…”

Bisphosphonates’ use and risk of aseptic loosening following total hip arthroplasty: a systematic review

“…Several factors may influence the risk of AL following THA. The THA-bearing surface markedly affects the AL risk, with ceramic-on-polyethylene being the most beneficial, followed by ceramic-on-ceramic, metal-onpolyethylene and finally by metal-on-metal bearing surfaces (51,52,53,54,55). Acetabular screws favor primary stability and ensure better cup osseointegration (56), and trabecular metal acetabular cups benefit long-term osseointegration (57).…”

Ceramic-related noise as an adverse outcome in total hip arthroplasty

“…Молодым и активным пациентам лучше предпочесть пару трения «керамика-полиэтилен», а на последующей ревизии сделать выбор пары «керамика-керамика», хотя Fang Y. и соавт. в мета-анализе сравнительных рандомизированных контролируемых исследованиий пар трения «керамика-керамика» и «керамика-полиэтилен» продемонстрировали незначительную разницу износа пар трения и несущественную статистическую разницу осложнений [88]. Jack C.M.…”