2009 Annual Meeting Podium Presentations

Adult Reconstruction Hip 3: Bearing Surfaces: Hard on Hard Bearings

Greater Prevalence of Early Complications with Ceramic-on-Ceramic than with Metal-on-Metal THAs

Podium No: 196

Thursday, February 26, 2009
08:00 AM - 08:06 AM

Location: Venetian Hotel
Venetian Ballroom I

Christian P Christensen, MD Lexington KY
Cale Jacobs, PhD Lexington KY

Moderator(s):
Ronald Emilio Delanois, MD Lutherville MD
Michael D Ries, MD San Francisco CA

Ceramic-ceramic hips demonstrated a significantly greater prevalence of technical complications in the early postoperative period compared to the metal-metal hips.

Hard bearings couples have demonstrated improved wear characteristics. Despite this, surgeons may be reluctant to utilize these bearings either due the risk of material fracture or squeak with ceramic-on-ceramic (C/C) hips, or the risk of complications stemming from the release of metal ions from metal-on-metal (M/M) hips. Additionally, there is a risk of less satisfactory outcomes or an increased risk of complication when a surgeon is utilizing a new implant. The purpose of this study was to determine if the respective learning curves associated with our initial experience with C/C and M/M bearings affected early complication rates and clinical outcomes.

We compared patient demographics, modified Harris Hip Scores, and complications occurring in the early postoperative period to determine if differences existed between our initial series of 75 C/C and 75 M/M hips.

There were no differences in patient demographics or modified Harris Hip Scores. In the C/C group, titanium-encased liners were malseated in 6/75 hips (8%) and 7/75 (9.3%) of have been reported to squeak. Four C/C hips (5.3%) were revised; 1 for recurrent dislocation, 1 for posterior impingement, 1 for femoral loosening, and 1 for acetabular loosening. In the M/M group, 1 hip (1.3%) was revised for femoral loosening. There was a significantly greater prevalence of technical complications with the C/C hips than M/M hips that have not required revised (12/71 vs. 0/74, p<0.001).

C/C hips demonstrated a significantly greater prevalence of technical complications in the early postoperative period compared to the M/M hips. The long-term benefit of improved wear characteristics of C/C hips may be overshadowed by inferior results in the early postoperative period.

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An alphabetical listing of disclosures will be available at a later time.

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