Alumina-on-alumina ceramic versus metal-on-highly cross-linked polyethylene bearings in total hip arthroplasty: a comparative study

Abstract

The aim of the study was to evaluate the reliability and durability of alumina-on-alumina ceramic in comparison to metal-on-highly cross-linked polyethylene (CoCr/HXLPE) bearing couples. This prospective randomised study involved 150 patients (157 hips). All patients (mean age: 54.7 years) obtained an identical fibre metal midcoat femoral stem and fibre metal-coated acetabular shell. In 78 patients (82 hips) we used alumina, while in 72 patients (75 hips) metal-polyethylene bearing couples were used. During a mean 50.4-month follow-up period (51 ± 8 alumina and 50 ± 8.9 metal-polyethylene) no statistically significant changes in clinical and radiographic parameters were noted between the two groups. There was no ceramic breakage and no need for revision surgery due to the ceramic liner. The alumina bearing couples proved to be as reliable as CoCr/HXLPE.

Figures

Fig. 1

Cluster-hole press fit shell, fibre metal-coated, alumina ceramic acetabular insert, alumina ceramic femoral head and porous collared stem, fibre metal midcoat (left). Multi-hole press fit shell, fibre metal-coated, cross-linked polyethylene acetabular insert, cobalt-chrome femoral head and porous collared stem, fibre metal midcoat (right)

Fig. 2

Intraoperative ceramic insert chip. Damage of the ceramic insert edge occurred during impaction due to insufficiently precise placement in the acetabular shell

Fig. 3

a Secondary degenerative disease of the left hip due to DDH in a 21-year-old woman, preoperative anteroposterior (AP) view. b The same patient, immediately after total hip arthroplasty (THA) with alumina bearing couple, AP view. c The same patient, 4 years postoperatively, AP view

Fig. 4

a Secondary degenerative disease of both hips due to DDH in a 30-year-old woman, preoperative AP view. b The same patient, 1 year after left THA with alumina bearing couple, AP view. c The same patient, 1 year postoperatively, lateral view. d The same patient, 4 years postoperatively, AP view