Comparison of Wear Rate between Ceramic-on-Ceramic, Metal on Highly Cross-linked Polyethylene, and Metal-on-Metal Bearings^[∗]

Abstract

Objective Currently, there is a lack of evidence on the medium-term follow-up of cementless total hip arthroplasty (THA) using metal on highly cross-linked polyethylene (MoP), ceramic-on-ceramic (CoC), and metal-on-metal (MoM) bearings. Our aim was to calculate the 5- to 10-year wear rate and the incidence rate of osteolysis for 3 types of bearings.

Methods A total of 77 patients underwent MoP, 105 underwent ceramic CoC, and 55 underwent MoM THAs. The average patient age at the time of surgery was 64.7, 55.9, and 59.9 years old in the MoP, CoC, and MoM bearings, respectively. Clinical and radiologic measurements at a mean follow-up of 7.6 years were analyzed.

Results The mean postoperative Harris hip scores showed no difference among the groups. The mean annual liner wear rates were 0.0160, 0.0040 and 0.0054 mm/year in MoP, CoC bearings, and MoM bearings, with that of CoC bearings being significantly lower than the others. Osteolysis (14.5%) among MoM bearings was significantly more frequently observed compared with the others. Kaplan-Meier survival at 10 years with implant loosening, or revision THA as the endpoint, was 96.1% (95% confidence interval [CI]: 88.4–98.7) for MoP, 98.6% (95% CI: 90.3–98.6) for CoC bearing, and 98.2% (95% CI: 88.0–99.7) for MoM bearings (p = 0.360).

Conclusion Excellent clinical and radiological outcomes were obtained for MoP and CoC bearings.

Keywords

arthroplasty - ceramics - metals - polyethylenes - prosthesis design

^∗ The present study was conducted at the Department of Orthopedic Surgery of the Nagoya University Graduate School of Medicine, Tsurumai-cho, Showa-ku Nagoya, Japan.

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