2017 ISAKOS Biennial Congress ePoster #601

 

Performance of Large Diameter Metal and Ceramic Heads on Highly Cross-Linked Polyethylene are Similar at 5-Year Follow-Up

Peter B. White, DO, Plainview, NY UNITED STATES
Narges Ghazi, MS, New York, NY UNITED STATES
Morteza Meftah, MD, New York, NY UNITED STATES
Amar S. Ranawat, MD, New York, NY UNITED STATES
Chitranjan S. Ranawat, MD, New York, NY UNITED STATES

Hospital for Special Surgery, New York, New York, UNITED STATES

FDA Status Cleared

Summary

This study evaluated the differences in 5 year wear rates for patients with large (32 or 36-mm) metal and ceramic heads on X3 polyethylene

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Abstract

Background

Wear and osteolysis are major factors limiting the durability of total hip arthroplasty (THA). Several studies have shown that ceramic heads provide less wear than metal heads on conventional polyethylene in THA, however, effect of larger head sizes on wear rates have not been established. Therefore, we sought to compare the wear rates of large (32- or 36-mm) ceramic and large metal heads on highly cross-linked polyethylene (HXLPE).

Methods

Patients who received a non-cemented THA with a large (32- or 36-mm) Delta ceramic head (n=44) were matched with patients who received a large metal head (n=44) based on gender, head size, follow-up and UCLA activity score. All cases utilized HXLPE. Linear wear rates were measured using the computer-assisted Roman software and were subsequently utilized to calculate volumetric wear rates.

Results

At 5 year follow-up, no statistical difference was observed in the best-case scenario linear wear rates between large ceramic and metal heads on HXLPE (0.017 mm/yr, 95% CI: 0 to 0.034; and 0.022 mm/yr, 95% CI: 0.003 to 0.041, respectively; p=0.699). Similarly, no difference was observed in the best-case scenario volumetric wear rates with large ceramic or metal heads (16.4 mm3/yr 95%, CI: 0.5 to 32.3; and 20.6 mm3/yr, 95% CI: 2.9 to 38.9 respectively; p=0.732). No patients had evidence of osteolysis on pelvic radiographs.

Conclusion

In this matched-pair study, no significant differences were observed in linear or volumetric wear rates at five years between large metal and large ceramic heads on HXLPE.