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Metasul vs Cerasul bearings: a prospective, randomized study at a mean eighteen years

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Abstract

Background

The aims of our study were to compare the clinical, radiographic outcomes and survivals between second-generation metal-on-metal (Metasul) and ceramic-on-ceramic (Cerasul) bearings at a very long-term follow-up.

Methods

A prospective, randomized study was originally performed on a consecutive series of 250 cementless, 28-mm head and primary total hip arthroplasties between 1999 and 2002. For each bearing (Metasul or Cerasul), 125 THAs were initially included. All cases were evaluated both clinically and radiographically, and survival was assessed, considering revisions for aseptic loosening or for any reason as the end points for failure.

Results

At a mean 18-year follow-up, clinical and radiographic outcomes were similar. Harris Hip Score increased 30% in the Metasul group and 32% in the Cerasul group (p = 0.6). Survival free of aseptic loosening was higher for Cerasul (100%), than for Metasul (94% [CI 88–99.9]) (p = 0.04). Survival free of any revision was 91% ([CI 84–98%]) for Cerasul and 91% ([CI 84–98%]) for Metasul. Fractures of Cerasul insert occurred in four cases (3%) at a mean 12.5 ± 3.3 years (range, 6 to 17 years).

Conclusion

At 18 years, Cerasul demonstrated higher survivorship than Metasul considering aseptic loosening as an end point. However, Cerasul liners had high rate of fracture because of its sandwich design (thin ceramic liner into polyethylene). These implants are no more available on the market.

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Authors and Affiliations

  1. Hospices Civils de Lyon, Hôpital Lyon Sud, Service de Chirurgie Orthopédique et Traumatologique, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite Cedex, France

    Quentin Andeol, Anthony Viste, Romain Desmarchelier, Jean-Luc Lerat & Michel-Henri Fessy

  2. Univ de Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMRT_9406, Lyon, France

    Anthony Viste & Michel-Henri Fessy

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  1. Quentin Andeol
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  2. Anthony Viste
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Correspondence to Anthony Viste.

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Conflict of interest

MHF perceives royalties from Serf and DePuy outside the submitted work. AV is consultant for Serf and educational consultant for Smith & Nephew outside the submitted work.

Ethical approval

It is a randomized control trial study (institutional review board 00001072). This study has been performed in accordance with the ethical standards in the 1964 Declaration of Helsinki.

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Andeol, Q., Viste, A., Desmarchelier, R. et al. Metasul vs Cerasul bearings: a prospective, randomized study at a mean eighteen years. International Orthopaedics (SICOT) 44, 2545–2551 (2020). https://doi.org/10.1007/s00264-020-04855-9

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  • DOI: https://doi.org/10.1007/s00264-020-04855-9

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