Significantly Lower Wear of Ceramic-on-Ceramic Bearings Than Metal-on-Highly Cross-Linked Polyethylene Bearings: A 10-to 14-Year Follow-Up Study

Background: This study aimed to retrospectively compare clinical and radiographic results between consecutive total hip arthroplasties (THAs) using ceramic on ceramic (CoC) and metal-on-highly crosslinked polyethylene (MoP), with >10 years of follow-up. Methods: Sixty-seven patients (52 women and 15 men) underwent CoC THA, whereas 81 (67 women and 14 men) underwent MoP THA. The average patient age at the time of surgery was 54.0 years in the CoC group and 54.2 years in the MoP group. Results: The mean postoperative Harris Hip Scores were 88.9 and 86.4 in the CoC and MoP groups, respectively (P = .063), and the mean annual liner rates of wear were 0.0043 and 0.0163 mm/year, respectively (P < .001). Osteolysis was observed on the femoral side of 1 joint (1.5%) in the CoC group and in 1 (1.2%) acetabular and femoral (1.2%) joint each in the MoP group. Three joints (3.7%) in the MoP group showed aseptic cup loosening, one of which (1.2%) required revision THA because of progression of the loosening. Revision THA was also required in 1 joint (1.5%) in the CoC group because of ceramic fracture. The Kaplan-Meier survival rate at 10 years with implant loosening or revision THA as the end point was 98.5% for CoC and 96.3% for MoP (P = .416). Conclusion: The wear rate of CoC implants was significantly lower than that of MoP implants. Kaplan-Meier survival at 10 years with implant loosening and revision THA as end points did not differ significantly between these implants. (C) 2015 Elsevier Inc. All rights reserved.