Alumina ceramic bearings for total hip arthroplasty: five-year results of a prospective randomized study.
Three hundred twenty-eight ceramic bearings were implanted by six surgeons in 316 patients as a part of a prospective randomized US Investigational Device Exemption study comparing alumina ceramic bearings with cobalt chrome-on-polyethylene bearings. There was no difference between the control metal-on-polyethylene and the alumina bearing couple patient cohorts regarding demographics or clinical scores through 7 years. Revision for any reason occurred in 2.7% of the patients with alumina bearings and 7.5% of the control patients with polyethylene bearings. Osteolysis was found in 1.4% of the patients with alumina bearings and in 14.0% of the control patients. At an average followup of 5.0 years (range, 1-86 months) no ceramic fractures or ceramic bearing failures have occurred. Results of this study suggest that alumina ceramics perform as well as the metal-on-polyethylene in clinical scores, but the patients with ceramic bearings had fewer revisions and less osteolysis. These results lead us to think that this new alumina ceramic bearing provides a safe option for younger and more active patients.


METHODS
Therapeutic study, Level I-1b (randomized controlled trial, no significant difference, but narrow confidence intervals). See the Guidelines for Authors for a complete description of levels of evidence.
D'Antonio
James
J
Greater Pittsburgh Orthopaedics Association, Moon Township, PA, USA. jadantonio@verizon.net
Capello
William
W
Manley
Michael
M
Naughton
Marybeth
M
Sutton
Kate
K
D000537:Aluminum Oxide; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D002857:Chromium; D003035:Cobalt; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery; D010014:Osteolysis / Q000453:epidemiology / Q000209:etiology; D020959:Polyethylene; D011183:Postoperative Complications; D011446:Prospective Studies; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation; D016896:Treatment Outcome
D002857:Chromium; D003035:Cobalt; D020959:Polyethylene; D000537:Aluminum Oxide