Ceramic-on-ceramic versus ceramic-on-polyethylene in total hip arthroplasty: a comparative study at a minimum of 13 years follow-up

Malerba Giuseppe; Basilico Mattia; Bonfiglio Nadia; Vitiello Raffaele; Ruberto Pasquale; D' Adamio Stefano; Sirgiovanni Mattia; De Santis Vincenzo; Maccauro Giulio

doi:10.1186/s12891-021-04950-x

Ceramic-on-ceramic versus ceramic-on-polyethylene in total hip arthroplasty: a comparative study at a minimum of 13 years follow-up

BMC Musculoskelet Disord. 2022 Jan 17;22(Suppl 2):1062. doi: 10.1186/s12891-021-04950-x.

Authors

Malerba Giuseppe¹, Basilico Mattia^{1

2}, Bonfiglio Nadia^{1

2}, Vitiello Raffaele^{3

4}, Ruberto Pasquale^{1

2}, D' Adamio Stefano^{1

2}, Sirgiovanni Mattia^{5

6}, De Santis Vincenzo^{1

2}, Maccauro Giulio^{1

2}

Affiliations

¹ Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
² Università Cattolica Del Sacro Cuore, Roma, Italy.
³ Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. lele.vitiello@gmail.com.
⁴ Università Cattolica Del Sacro Cuore, Roma, Italy. lele.vitiello@gmail.com.
⁵ Department of Medical Oncology and Pneumology, University Hospital Tuebingen, Tuebingen, Germany.
⁶ Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", University of Tuebingen, Tuebingen, Germany.

Abstract

Background: Nowadays hip replacement is one of the most successful surgery in terms of clinical outcome and patient's satisfaction. Therefore, the choice of biomaterials in hip replacement is increasingly important with the aim of obtaining a long-term satisfaction of patient and a greater survivorship of the implants. Ceramic-on-polyethylene (COP) and ceramic-on-ceramic (CoC) bearings are two common coupling used in total hip arthroplasty. The aim of this retrospective study was to compare clinical and radiological outcomes between patients treated using CoC and CoP THA at a mean follow-up of 15 years.

Methods: 86 patients, average age 65.6, were included in the study: 43 in group A bearing CoC and 43 in group B bearing CoP. Minimum follow-up was 13 years. Primary outcome was a clinical evaluation assessed by HOOS and SF-12 questionnaires. Secondary outcome was a radiological evaluation on a A-P pelvis x-ray calculating acetabular cup inclination and anteversion and detecting osteolysis.

Result: After a multivariate analysis was performed, our results show clinical outcomes in group B significantly better than in group A: statistically significant value (p < 0,05) was found in the mean HOOS-symptoms subscale (83.0 ± 15.4 in Group A vs 90.3 ± 12.2 in group B) in the SF-12 physical component score (39.7 ± 11.0 in Group A vs 48.1 ± 10.1 in group B) and in HOOS (79.0 ± 16 in Group A vs 87.0 ± 16 in group B). 3 squeaking was found in group A. The calculated mean acetabular cup inclination value was 44,87 in group A and 44,5 in group B and the mean socket version was 17,54 in group A and 15,10 in group B. No significant statistically relationship between radiographic parameters analyzed and clinical outcomes was noted.

Conclusion: The current results provide us important information about the THA long-term outcome. CoP offered significantly better results compared with CoC at long-term follow up, and thus it should be considered in the choose of bearing in THA.

Keywords: Ceramic; Hip; Polyethylene; Replacement; Wear, outcomes.

MeSH terms

Aged
Arthroplasty, Replacement, Hip* / adverse effects
Ceramics
Follow-Up Studies
Hip Prosthesis*
Humans
Polyethylene
Prosthesis Design
Prosthesis Failure
Reoperation
Retrospective Studies
Treatment Outcome

Substances

Polyethylene