Ceramic femoral heads were developed to reduce the wear of conventional ultrahigh-molecularweight polyethylene (UHMWPE) bearing surfaces in THA. We compared the wear rates of PE acetabular components bearing against femoral heads of zirconia (Zr) or cobaltchromium (CoCr) in young patients. One surgeon inserted CoCr femoral heads in all 33 patients (33 hips) having THA for primary osteoarthritis from 1996 to 1997 and then Zr femoral heads in all 34 patients (36 hips) from 1998 to 1999. The mean age of the entire cohort was 52.5 years (range, 29-64 years). The shells were solid and hydroxyapatite (HA) -coated, liners were argon-sterilized UHMWPE, and head size was 28 mm. The minimum clinical followup was 56 months (mean, 65 months; range, 56-77 months); minimum 5-year radiographs were available for 62 of the 68 patients. Wear analysis of digitized anteroposterior (AP) radiographs was performed with a computerized method. Demographic data were comparable in the two groups.Mean femoral head penetration rate was similar in the two types of heads (CoCr: 0.25 mm/year; range, 0.21-0.33 mm/ year; Zr: 0.23 mm/year; range, 0.20-0.29 mm/year), as was mean linear wear (CoCr: 1.22 mm; range, 0.28-3.78 mm; Zr: 1.11 mm; range, 0.15-2.05 mm). There were no revisions. These data support skepticism regarding the clinical wear advantage of Zr compared with CoCr femoral heads. The explanation for the clinical similarity of wear, despite the theoretical advantages of ceramic heads, needs further investigation.

Plaster of Paris and Hexelite, a new thermoplastic bandage, were compared in the treatment of 183 patients with malleolar fractures, Colles' fractures or distortions of the finger joints. There were no statistically significant differences between the two types of bandages taking into account the strength of the bandage, the amount of skin damage and the patient's opinion of the bandage. Hexelite is seven times more expensive than plaster of Paris, and, in addition, is more difficult to handle. Hence its use has been discontinued.