Polyethylene Wear With Ceramic and Metal Femoral Heads at 5 Years : A Randomized Controlled Trial With Radiostereometric Analysis
(2020) In Journal of Arthroplasty 35(12). p.3769-3776- Abstract
Background: A common bearing combination in total hip arthroplasty today is a metal femoral head articulating with polyethylene in the cup. Ceramic heads are thought to be more resistant to third-body damage, and have better wettability and decreased surface roughness, which taken together have been suggested to result in less polyethylene wear. The purpose of this study is to compare the initial creep deformation and follow wear pattern, using radiostereometric analysis, of ceramic and metal femoral heads that articulate with a modern highly cross-linked polyethylene cup liner. Methods: Fifty patients with primary osteoarthritis and scheduled for an uncemented total hip arthroplasty were randomized 1:1 to either a ceramic (BIOLOX... (More)
Background: A common bearing combination in total hip arthroplasty today is a metal femoral head articulating with polyethylene in the cup. Ceramic heads are thought to be more resistant to third-body damage, and have better wettability and decreased surface roughness, which taken together have been suggested to result in less polyethylene wear. The purpose of this study is to compare the initial creep deformation and follow wear pattern, using radiostereometric analysis, of ceramic and metal femoral heads that articulate with a modern highly cross-linked polyethylene cup liner. Methods: Fifty patients with primary osteoarthritis and scheduled for an uncemented total hip arthroplasty were randomized 1:1 to either a ceramic (BIOLOX delta) or a metal (CoCr) femoral head. The patients were followed up for 5 years with repeated radiostereometric analysis examinations (postoperatively, then at 14 days, 3, 12, 24, and 60 months), as well as a hip-specific outcome questionnaire. Results: During the first 3 months both groups showed expected creep within the liner of 0.12 mm (standard deviation 0.03) for the ceramic and 0.08 mm (standard deviation 0.02) for the metal heads. Between 3 months and 5 years there was very little wear of the liner in either group, corresponding to 0.003 mm/y for ceramic and 0.007 mm/y for metal heads. There was no difference in cup migration or clinical outcome between the groups and no cups were revised. Conclusion: With the introduction of modern highly cross-linked polyethylene, the ceramic head demonstrates no superiority when it comes to either early deformation or polyethylene wear compared with the metal head.
(Less)
- author
- Bergvinsson, Halldor LU ; Sundberg, Martin LU and Flivik, Gunnar LU
- organization
- publishing date
- 2020-12-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- ceramic, CoCr, radiostereometric analysis, total hip arthroplasty, uncemented, wear
- in
- Journal of Arthroplasty
- volume
- 35
- issue
- 12
- pages
- 8 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85089002456
- pmid:32763006
- ISSN
- 0883-5403
- DOI
- 10.1016/j.arth.2020.06.057
- language
- English
- LU publication?
- yes
- id
- f95767ad-c250-4119-b659-2d33750e618e
- date added to LUP
- 2020-08-13 13:34:27
- date last changed
- 2024-03-20 14:03:45
@article{f95767ad-c250-4119-b659-2d33750e618e, abstract = {{<p>Background: A common bearing combination in total hip arthroplasty today is a metal femoral head articulating with polyethylene in the cup. Ceramic heads are thought to be more resistant to third-body damage, and have better wettability and decreased surface roughness, which taken together have been suggested to result in less polyethylene wear. The purpose of this study is to compare the initial creep deformation and follow wear pattern, using radiostereometric analysis, of ceramic and metal femoral heads that articulate with a modern highly cross-linked polyethylene cup liner. Methods: Fifty patients with primary osteoarthritis and scheduled for an uncemented total hip arthroplasty were randomized 1:1 to either a ceramic (BIOLOX delta) or a metal (CoCr) femoral head. The patients were followed up for 5 years with repeated radiostereometric analysis examinations (postoperatively, then at 14 days, 3, 12, 24, and 60 months), as well as a hip-specific outcome questionnaire. Results: During the first 3 months both groups showed expected creep within the liner of 0.12 mm (standard deviation 0.03) for the ceramic and 0.08 mm (standard deviation 0.02) for the metal heads. Between 3 months and 5 years there was very little wear of the liner in either group, corresponding to 0.003 mm/y for ceramic and 0.007 mm/y for metal heads. There was no difference in cup migration or clinical outcome between the groups and no cups were revised. Conclusion: With the introduction of modern highly cross-linked polyethylene, the ceramic head demonstrates no superiority when it comes to either early deformation or polyethylene wear compared with the metal head.</p>}}, author = {{Bergvinsson, Halldor and Sundberg, Martin and Flivik, Gunnar}}, issn = {{0883-5403}}, keywords = {{ceramic; CoCr; radiostereometric analysis; total hip arthroplasty; uncemented; wear}}, language = {{eng}}, month = {{12}}, number = {{12}}, pages = {{3769--3776}}, publisher = {{Elsevier}}, series = {{Journal of Arthroplasty}}, title = {{Polyethylene Wear With Ceramic and Metal Femoral Heads at 5 Years : A Randomized Controlled Trial With Radiostereometric Analysis}}, url = {{http://dx.doi.org/10.1016/j.arth.2020.06.057}}, doi = {{10.1016/j.arth.2020.06.057}}, volume = {{35}}, year = {{2020}}, }