Biomaterial Database

Ceramic on Ceramic or Ceramic-on-polyethylene for Total Hip Arthroplasty: A Systemic Review and Meta-analysis of Prospective Randomized Studies. 2015

Yu-Lei Dong, and Tao Li, and Ke Xiao, and Yan-Yan Bian, and Xi-Sheng Weng

BACKGROUND Wear debris of polyethylene has become a restraining factor of the durability for total hip arthroplasty (THA). Ceramic on ceramic (COC) has better wear resistance while the squeaking sound and prosthesis fracture are of concern. It is still a controversy that bearing couples are better for THA. METHODS We performed a systematic review of all English articles identiﬁed from PubMed (1966-), Embase (1980-) and the Cochrane Library. Clinical outcomes, complications, revision rates, and radiographic outcomes of COC-THA and ceramic on polyethylene (COP)-THA were compared and evaluated. RESULTS Eight prospective randomized trials enrolling a total of 1508 patients and 1702 THA surgeries were identiﬁed. Our results demonstrated the prosthesis fracture and the squeaking sound is significantly higher in COC group and higher wear rate of the COP. Hip function, loosening rate, dislocation rate, revision rate, and the osteolysis rate were comparable between two groups. According to Grading of Recommendations Assessment, Development and Evaluation system assessment, the strength of evidence was high for prosthesis fracture, dislocation, osteolysis, and moderate for radiolucent line or loosening, hip noise, and revision. CONCLUSIONS Up to now, there is insufﬁcient evidence to identify any clinical advantage of COC compared with COP. Longer follow-up of larger randomized trial is needed to clarify the outcomes.

UI	MeSH Term	Description	Entries
D002516	Ceramics	Products made by baking or firing nonmetallic minerals (clay and similar materials). In making dental restorations or parts of restorations the material is fused porcelain. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed & Boucher's Clinical Dental Terminology, 4th ed)	Ceramic
D006622	Hip Prosthesis	Replacement for a hip joint.	Femoral Head Prosthesis,Femoral Head Prostheses,Hip Prostheses,Prostheses, Femoral Head,Prostheses, Hip,Prosthesis, Femoral Head,Prosthesis, Hip
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D019644	Arthroplasty, Replacement, Hip	Replacement of the hip joint.	Hip Prosthesis Implantation,Hip Replacement, Total,Total Hip Arthroplasty,Arthroplasties, Hip Replacement,Arthroplasties, Replacement, Hip,Arthroplasty, Hip Replacement,Hip Replacement Arthroplasties,Hip Replacement Arthroplasty,Replacement Arthroplasties, Hip,Replacement Arthroplasty, Hip,Replacement, Total Hip,Total Hip Replacement,Arthroplasty, Total Hip,Hip Arthroplasty, Total,Hip Prosthesis Implantations,Implantation, Hip Prosthesis,Prosthesis Implantation, Hip,Total Hip Arthroplasties,Total Hip Replacements
D020959	Polyethylene	A vinyl polymer made from ethylene. It can be branched or linear. Branched or low-density polyethylene is tough and pliable but not to the same degree as linear polyethylene. Linear or high-density polyethylene has a greater hardness and tensile strength. Polyethylene is used in a variety of products, including implants and prostheses.	HDPE,High-Density Polyethylene,Polythene,LDPE,Low-Density Polyethylene,High Density Polyethylene,Low Density Polyethylene,Polyethylene, High-Density,Polyethylene, Low-Density