title: Comparison of the risk of revision in cementless total hip arthroplasty with ceramic-on-ceramic and metal-on-polyethylene bearings.
abstract: OBJECTIVE
  Ceramic-on-ceramic (CoC) bearings were introduced in total hip arthroplasty (THA) to reduce problems related to polyethylene wear. We compared the 9-year revision risk for cementless CoC THA and for cementless metal-on-polyethylene (MoP) THA.
  
  
  METHODS
  In this prospective, population-based study from the Danish Hip Arthroplasty Registry, we identified all the primary cementless THAs that had been performed from 2002 through 2009 (n = 25,656). Of these, 1,773 THAs with CoC bearings and 9,323 THAs with MoP bearings were included in the study. To estimate the relative risk (RR) of revision, we used regression with the pseudo-value approach and treated death as a competing risk.
  
  
  RESULTS
  444 revisions were identified: 4.0% for CoC THA (71 of 1,773) and 4.0% for MoP THA (373 of 9,323). No statistically significant difference in the risk of revision for any reason was found for CoC and MoP bearings after 9 years of follow-up (adjusted RR = 1.3, 95% CI: 0.72-2.4). Revision rates due to component failure were 0.5% (n = 8) for CoC bearings and 0.1% (n = 6) for MoP bearings (p < 0.001). 6 patients with CoC bearings (0.34%) underwent revision due to ceramic fracture.
  
  
  CONCLUSIONS
  When compared to the "standard" MoP bearings, CoC THA had a 33% higher (though not statistically significantly higher) risk of revision for any reason at 9 years.
authors: Department of Orthopedic Surgery and Traumatology , Odense University Hospital , Odense.
authors: Claus
authors: C
authors: Varnum
authors: Alma B
authors: AB
authors: Pedersen
authors: Per
authors: P
authors: Kjærsgaard-Andersen
authors: Søren
authors: S
authors: Overgaard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods*; D002516:Ceramics; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D005271:Femur Head Necrosis / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008670:Metals; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery; D020959:Polyethylene; D011446:Prospective Studies; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals; D020959:Polyethylene
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