Ceramic Versus Metal Femoral Heads in Combination With Polyethylene Cups

Ihle, Martin; Mai, Sabine; Siebert, W.

doi:10.1053/j.sart.2011.09.001

Cited by 6 publications

(5 citation statements)

References 28 publications

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“…However, debate remains regarding the optimal femoral head composition and size. Long-term results of convention polyethylene (CPE) suggest that ceramic ball bearings are superior to metal in terms of generating less wear and leading to fewer revisions for osteolysis [20, 34]. Numerous previous studies have examined wear and survivorship differences between varying femoral head sizes.…”

Section: Discussionmentioning

confidence: 99%

“…insuring proper component positioning) and conscientious selection of bearing components with the primary goal to prolong implant survivorship [12, 21, 36]. Some authors have championed ceramic-on-polyethylene as the preferred bearing combination for young THA patients because of its optimization of surface toughness and wettability of the femoral head, which leads to an overall decreased wear profile in combination with modern HXLPE [11, 20, 27]. As for the optimum head size, it is well documented that larger heads are associated with increased rates of linear and volumetric polyethylene wear [1, 28].…”

Section: Introductionmentioning

confidence: 99%

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Gender Differences in Wear Rates for 28- vs 32-mm Ceramic Femoral Heads on Modern Highly Cross-linked Polyethylene at Midterm Follow-Up in Young Patients Undergoing Total Hip Arthroplasty

Stambough

Pashos

et al. 2016

The Journal of Arthroplasty

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Background We report on the midterm linear and volumetric wear of highly cross-linked polyethylene (HXLPE) and survivorship of two prospective young THA cohorts that differed by the size of ceramic femoral head used: 28 vs. 32 millimeters. Methods We prospectively analyzed 220 consecutive primary THAs in patients ≤50 years who received a cementless THA with a ceramic femoral head on HXLPE liner (C-HXLPE). There were 101 patients (46%) with 28mm heads and 119 patients (54%) who received 32mm heads at a mean follow-up of 5.5 years (range 60–109 months). Wear was calculated using Martell Software. Results The 28mm C-HXLPE cohort demonstrated average linear and volumetric wear of 0.020 mm/year (SD 0.074, 95% CI [0.003, 0.037]) and 18.775 mm3/yr (SD 21.743, 95% CI [13.773, 23.778]) compared to 0.032 mm/yr (SD 0.087, 95% CI [0.013, 0.050]) and 29.847 mm3/yr (SD 35.441, 95% CI [22.294, 37.401]) in the 32mm C-HXLPE group. Subgroup analysis by gender and head size discovered significantly greater wear in females with 32mm compared to 28mm heads in both linear (0.01, 95% CI [−0.014, 0.033] vs. 0.048, 95% CI [0.022, 0.074] mm/y, p=0.004) and volumetric wear (14.11, 95% CI [8.957, 19.271] vs. 29.71, 95% CI [17.584, 41.840] mm3/yr, p=0.009). We found a 96% (95% CI [92.30%, 97.94%]) survivorship by Kaplan-Meier analysis at minimum 5-years with no failures due to osteolysis. Conclusions Ceramic-on-HXLPE demonstrates extremely low wear properties in young patients at midterm follow-up. We identified a gender-dependent difference in wear based on head size, with 32mm heads being associated with increased wear in females.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Gender Differences in Wear Rates for 28- vs 32-mm Ceramic Femoral Heads on Modern Highly Cross-linked Polyethylene at Midterm Follow-Up in Young Patients Undergoing Total Hip Arthroplasty

Stambough

Pashos

et al. 2016

The Journal of Arthroplasty

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“…Similarly, Cohn demonstrated that there was no difference in wear between zirconium and cobalt-chromium heads at four years [ 172 ]. At the same time, Ihle et al [ 173 ] demonstrated a halving of wear in the case of alumina compared to cobalt-chromium at 20 years.…”

Section: The Choices Of the Bearing Surfacesmentioning

confidence: 97%

Updates on Biomaterials Used in Total Hip Arthroplasty (THA)

et al. 2023

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One of the most popular and effective orthopedic surgical interventions for treating a variety of hip diseases is total hip arthroplasty. Despite being a radical procedure that involves replacing bone and cartilaginous surfaces with biomaterials, it produces excellent outcomes that significantly increase the patient’s quality of life. Patient factors and surgical technique, as well as biomaterials, play a role in prosthetic survival, with aseptic loosening (one of the most common causes of total hip arthroplasty failure) being linked to the quality of biomaterials utilized. Over the years, various biomaterials have been developed to limit the amount of wear particles generated over time by friction between the prosthetic head (metal alloys or ceramic) and the insert fixed in the acetabular component (polyethylene or ceramic). An ideal biomaterial must be biocompatible, have a low coefficient of friction, be corrosion resistant, and have great mechanical power. Comprehensive knowledge regarding what causes hip arthroplasty failure, as well as improvements in biomaterial quality and surgical technique, will influence the survivability of the prosthetic implant. The purpose of this article was to assess the benefits and drawbacks of various biomaterial and friction couples used in total hip arthroplasties by reviewing the scientific literature published over the last 10 years.

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“…The most comprehensive study 46 comparing long term outcomes with alumina versus cobalt-chrome prospectively followed up 93 arthroplasties for twenty years with none lost to follow-up. Linear wear involving the alumina head was half that for the cobalt chrome resulting in significantly lower rates of osteolysis and revision surgery.…”

Section: Clinical Studiesmentioning

confidence: 99%

The case for ceramic-on-polyethylene as the preferred bearing for a young adult hip replacement

Cash

Khanduja

2014

HIP International

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The optimum choice of bearing surfaces in total hip arthroplasty, particularly in the younger and more active patient, remains controversial. Despite several studies demonstrating good long-term results for the metal-on-polyethylene articulation, there has been a recent vogue towards the utilisation of hard-on-hard bearings for younger patients due, in part, to concerns regarding polyethylene induced osteolysis. However, well-documented complications concerning metal-on-metal bearings and the risk of fracture in ceramic-on-ceramic bearings have raised concerns regarding the principle of the hard-on-hard bearing in the active patient. With recent technological advancements in the manufacture of both polyethylene and alumina ceramics, the in vitro properties of each material with regards to strength and toughness have been significantly improved. In addition, ceramic femoral heads have consistently been shown to produce less in vivo polyethylene wear than similar sized metal heads. This paper aims to critically review the biomechanical, in vivo and clinical studies related to the use of the ceramic on polyethylene bearing, and highlights its potential use as the preferred bearing for a young adult hip replacement.

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Ceramic Versus Metal Femoral Heads in Combination With Polyethylene Cups

Cited by 6 publications

References 28 publications

Gender Differences in Wear Rates for 28- vs 32-mm Ceramic Femoral Heads on Modern Highly Cross-linked Polyethylene at Midterm Follow-Up in Young Patients Undergoing Total Hip Arthroplasty

Gender Differences in Wear Rates for 28- vs 32-mm Ceramic Femoral Heads on Modern Highly Cross-linked Polyethylene at Midterm Follow-Up in Young Patients Undergoing Total Hip Arthroplasty

Updates on Biomaterials Used in Total Hip Arthroplasty (THA)

The case for ceramic-on-polyethylene as the preferred bearing for a young adult hip replacement

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