Ceramic on Ceramic or Ceramic-on-polyethylene for Total Hip Arthroplasty: A Systemic Review and Meta-analysis of Prospective Randomized Studies

Overview

Journal Chin Med J (Engl)

Specialty General Medicine

Date 2015 May 8

PMID 25947407

Citations 8

Authors

Yu-Lei Dong

Tao Li

Ke Xiao

Yan-Yan Bian

Xi-Sheng Weng

Affiliations

Soon will be listed here.

Abstract

Background: Wear debris of polyethylene has become a restraining factor of the durability for total hip arthroplasty (THA). Ceramic on ceramic (COC) has better wear resistance while the squeaking sound and prosthesis fracture are of concern. It is still a controversy that bearing couples are better for THA.

Methods: We performed a systematic review of all English articles identiﬁed from PubMed (1966-), Embase (1980-) and the Cochrane Library. Clinical outcomes, complications, revision rates, and radiographic outcomes of COC-THA and ceramic on polyethylene (COP)-THA were compared and evaluated.

Results: Eight prospective randomized trials enrolling a total of 1508 patients and 1702 THA surgeries were identiﬁed. Our results demonstrated the prosthesis fracture and the squeaking sound is significantly higher in COC group and higher wear rate of the COP. Hip function, loosening rate, dislocation rate, revision rate, and the osteolysis rate were comparable between two groups. According to Grading of Recommendations Assessment, Development and Evaluation system assessment, the strength of evidence was high for prosthesis fracture, dislocation, osteolysis, and moderate for radiolucent line or loosening, hip noise, and revision.

Conclusions: Up to now, there is insufﬁcient evidence to identify any clinical advantage of COC compared with COP. Longer follow-up of larger randomized trial is needed to clarify the outcomes.

Citing Articles

Ceramic-on-ceramic metal-on-crosslink polyethylene in a fully hydroxyapatite-coated total hip arthroplasty: Survivorship, complications and long-term results.

Cordero-Ampuero J, Velasco P, Payo-Rodriguez J, Penalver-Andrada P, Gonzalez-Fernandez E J Clin Orthop Trauma. 2024; 57:102555.

PMID: 39430648 PMC: 11483472. DOI: 10.1016/j.jcot.2024.102555.

Comparative postoperative prognosis of ceramic-on-ceramic and ceramic-on-polyethylene for total hip arthroplasty: an updated systematic review and meta-analysis.

Wu T, Jiang Y, Shi W, Wang Y, Li T PeerJ. 2024; 12:e18139.

PMID: 39346065 PMC: 11438439. DOI: 10.7717/peerj.18139.

Head, acetabular liner composition, and rate of revision and wear in total hip arthroplasty: a Bayesian network meta-analysis.

Merfort R, Maffulli N, Hofmann U, Hildebrand F, Simeone F, Eschweiler J Sci Rep. 2023; 13(1):20327.

PMID: 37989863 PMC: 10663607. DOI: 10.1038/s41598-023-47670-z.

Revision in Ceramic-on-Ceramic and Ceramic-on-Polyethylene Bearing in Primary Total Hip Arthroplasty with Press-fit Cups: A Systematic Review and Meta-analysis of Different Methodological Study Designs.

van Loon J, de Graeff J, Sierevelt I, Opdam K, Poolman R, Kerkhoffs G Arch Bone Jt Surg. 2022; 10(11):916-936.

PMID: 36561219 PMC: 9749123. DOI: 10.22038/ABJS.2022.59354.2933.

The Wear Rate and Survivorship in Total Hip Arthroplasty Using a Third-generation Ceramic Head on a Conventional Polyethylene Liner: A Minimum of 15-year Follow-up.

Shim B, Park S, Park C Hip Pelvis. 2022; 34(2):115-121.

PMID: 35800129 PMC: 9204242. DOI: 10.5371/hp.2022.34.2.115.

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