title: A Randomized Trial Comparing Ceramic-on-Ceramic Bearing vs Ceramic-on-Crossfire-Polyethylene Bearing Surfaces in Total Hip Arthroplasty.
abstract: Bearing surfaces in total hip arthroplasty (THA) may affect implant longevity and hence patient outcomes. This randomized clinical trial determined how ceramic-on-ceramic (CERAMIC) bearing THA affected joint-specific pain, function, and stiffness and prosthesis fixation/longevity over 10 postoperative years compared with ceramic-on-highly-crosslinked-polyethylene (POLYETHYLENE) bearing THA. This is a follow-up to previously reported 5-year outcomes.
  
  
  
  Subjects aged <61 years were randomized to CERAMIC (n = 48) or POLYETHYLENE (n = 44) THA. Subjects were assessed using the Western Ontario McMaster Osteoarthritis Index and the RAND 12-Item Health Survey preoperatively, and at 1, 5, and 10 years postoperatively. Plain radiographs were evaluated at 10 years for fixation, and medical records were reviewed for revisions.
  
  
  
  Of 92 subjects, 6 (7%) died within 10 years; 68 (79%) survivors provided radiographic and/or clinical follow-up at 10 years postoperatively. Improvements seen at 5 years in both the Western Ontario McMaster Osteoarthritis Index and RAND 12-Item Health Survey were retained at 10 years with no group differences (P > .48). There were no failures or loss of fixation related to bearing surfaces/wear in either group. Over 10 years, 3 subjects in the POLYETHYLENE group had revisions that were related to recurrent dislocation; 2 revisions were performed within 2 years of surgery, and one further subject underwent revision at 7 years postoperatively.
  
  
  
  This is one of the first randomized clinical trials to examine 10-year outcomes between CERAMIC and POLYETHYLENE bearing THAs. Both bearing surfaces performed well out to 10 years in subjects who were <61 years at time of surgery.
authors.affiliation: Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada; Division of Orthopaedic Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Beaupre
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Amro
authors.initials: A
authors.lastname: Al-Houkail
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Donald William C
authors.initials: DWC
authors.lastname: Johnston
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002516:Ceramics / Q000737:chemistry*; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010003:Osteoarthritis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D020959:Polyethylene / Q000737:chemistry*; D011184:Postoperative Period; D011474:Prosthesis Design; D060489:Prosthesis Retention; D011788:Quality of Life; D012086:Reoperation; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D020959:Polyethylene
keywords: bearing surfaces; function; health-related quality of life; revision; total hip arthroplasty