Clinical Orthopaedics and Related Research®

, Volume 470, Issue 2, pp 382–387

Causes of Failure of Ceramic-on-Ceramic and Metal-on-Metal Hip Arthroplasties

  • Manny Porat
  • Javad Parvizi
  • Peter F. Sharkey
  • Keith R. Berend
  • Adolph V. LombardiJr
  • Robert L. Barrack
Symposium: Papers Presented at the Annual Meetings of The Hip Society

DOI: 10.1007/s11999-011-2161-y

Cite this article as:
Porat, M., Parvizi, J., Sharkey, P.F. et al. Clin Orthop Relat Res (2012) 470: 382. doi:10.1007/s11999-011-2161-y

Abstract

Background

Few large series of hard bearing surfaces have reported on reasons for early failure. A number of unique mechanisms of failure, including fracture, squeaking, and adverse tissue reactions, have been reported with these hard bearing surfaces. However, the incidence varies among the published studies.

Questions/purposes

To confirm the incidences, we identified the etiologies of early failures of hard-on-hard bearing surfaces for ceramic-on-ceramic and metal-on-metal THAs.

Methods

We retrospectively reviewed records of 2907 THAs with hard-on-hard bearing surfaces implanted between 1996 and 2009; 1697 (58%) had ceramic-on-ceramic and 1210 (42%) had metal-on-metal bearing surfaces. We recorded bearing-related complications and compared them to nonspecific reasons for revision THA. The minimum followup of the ceramic-on-ceramic and metal-on-metal cohorts was 6 months (mean, 48 months; range, 6–97 months) and 24 months (mean, 60 months; range, 24–178 months), respectively.

Results

The overall revision rate for ceramic-on-ceramic THA was 2.2% (38 of 1697), with aseptic loosening accounting for 55% of revisions (femur or acetabulum). The bearing accounted for 13% of the revisions in the ceramic-on-ceramic THA cohort. The overall metal-on-metal revision rate was 5.4% (65 of 1210), 17 involving adverse tissue reactions related to the metal-on-metal bearing surface (17 of 1210, 1.4% of cases; 17 of 65, 26% of revisions).

Conclusions

Twenty-six percent of the revisions from metal-on-metal and 13% of ceramic-on ceramic were bearing related. The overall short- to medium-term revision rate was 2.2% and 5.4% for ceramic-on-ceramic and metal-on-metal, respectively. The most common etiology of failure was loosening of the femoral or acetabular components.

Level of Evidence

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of level of evidence.

Copyright information

© The Association of Bone and Joint Surgeons® 2011

Authors and Affiliations

  • Manny Porat
    • 1
  • Javad Parvizi
    • 1
  • Peter F. Sharkey
    • 1
  • Keith R. Berend
    • 2
  • Adolph V. LombardiJr
    • 2
  • Robert L. Barrack
    • 3
  1. 1.Rothman Institute at Thomas Jefferson UniversityPhiladelphiaUSA
  2. 2.Joint Implant Surgeons, IncNew AlbanyUSA
  3. 3.Department of Orthopaedic SurgeryWashington University School of Medicine, One Barnes-Jewish Hospital PlazaSt LouisUSA