Ceramic-on-ceramic versus ceramic-on-polyethylene bearing surfaces in total hip arthroplasty: a meta analysis of efficacy and safety

doi:10.3969/j.issn.2095-4344.2016.04.025

Abstract

Abstract:

BACKGROUND: Greatly importance has been attached to ceramic-on-ceramic bearing surface due to its excellent wear resistance. But the risks of squeaking and ceramic fracture also go with it. Up till now, the choice between ceramic-on-ceramic and ceramic-on-polyethylene bearing surfaces in primary total hip arthroplasty remains controversial.
OBJECTIVE: To compare the clinical outcomes and safety between ceramic-on-ceramic versus ceramic-on-polyethylene bearing surfaces in total hip arthroplasty based on meta analysis.
METHODS: We electronically searched databases including PubMed/Medline, Embase, Web of Science, Cochrane Collaboration database, Chinese Biomedical Literature Database (CBMdisc) and China National Knowledge Internet for randomized controlled trials on the comparison between ceramic-on-ceramic versus ceramic-on-polyethylene bearing surfaces in total hip arthroplasty from inception to January 2015. References of the included studies were also retrieved. Investigators severely selected the studies, extracted data and assessed the quality according to the inclusion and exclusion criteria. Then, meta-analysis was performed using RevMan 5.2 software.
RESULTS AND CONCLUSION: Nine randomized controlled trials were included, involving 1 231 hips with ceramic-on-ceramic prosthesis and 932 hips with ceramic-on-polyethylene prosthesis. Meta analysis showed that both bearing surfaces achieved satisfied function recovery. But ceramic-on-ceramic had significantly increased risks of squeaking and ceramic fracture, meanwhile ceramic-on-polyethylene showed significantly higher wear rate. There were no significant differences in intra- or post-operative dislocation, osteolysis and other complications and prosthesis failure with any reason between two bearing surfaces. These results suggest that during the short- to mid-term follow-up period, no sufficient evidence can tell that ceramic-on-ceramic was obviously super than ceramic-on-polyethylene. Long-term follow-up is required for further evaluation.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Mohammed Alezzi Mohammed, Fang Shu-ying, Liao Wei-ming, Zhao Xiao-yi, Luo Jia-yue, Zhang Zi-ji. Ceramic-on-ceramic versus ceramic-on-polyethylene bearing surfaces in total hip arthroplasty: a meta analysis of efficacy and safety[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(4): 595-601.

Figures/Tables 6

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