Published online Jan 18, 2021. doi: 10.5312/wjo.v12.i1.14
Peer-review started: August 5, 2020
First decision: November 4, 2020
Revised: November 4, 2020
Accepted: November 12, 2020
Article in press: November 12, 2020
Published online: January 18, 2021
Ceramic-on-ceramic (CoC) bearing in total hip arthroplasty (THA) is presumed to give lower wear rates in vivo, compared to ceramic-on-polyethylene (CoPE).
More in vivo long-term studies are needed in literature, to confirm potential benefits or disadvantages of CoC over CoPE.
The objective of this study was to determine the 10-year difference in wear, identify potential predictive factors for wear, investigate radiological findings such as osteolysis, evaluate clinical functioning and complications between CoC bearing vs CoPE when using the same implants.
An observational prospective single-center cohort study with 10-year follow-up of a documented series of elective THAs was performed with either a ceramic (BIOLOX delta, Smith and Nephew) or a standard PE acetabular insert (Standard REXPOL, Smith and Nephew) with a similar ceramic head (BIOLOX delta, Smith and Nephew) articulation.
Higher wear rates were observed in CoPE compared to CoC bearing after 10-year follow-up with cup inclination as a predictive factor for wear for CoPE bearing, and no differences in complications, Harris hip score, and radiological findings.
The potential benefit of CoC over CoPE at the 10-year follow-up is less wear with cup inclination as a predictive factor for wear, without differences in clinical or radiological outcomes.
Further investigation of wear, revision, and complication rates between CoC and CoPE, especially in the long-term, should be done, to confirm potential benefits of CoC over CoPE and to prove if it can improve the longevity of THAs. In addition, long-term analysis needs to clarify if differences in outcomes, complication, and revision rates are cost-effective to the costs of both bearings.