Comparison of ceramic-on-ceramic to metal-on-polyethylene bearing surfaces in total hip arthroplasty: a meta-analysis of randomized controlled trials

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• 作者：Dongcai Hu (1)
  Kai Tie (1)
  Xiao Yang (2)
  Yang Tan (1)
  Mohammed Alaidaros (1)
  Liaobin Chen (1)
  
  1. Department of Orthopaedic Surgery ; Zhongnan Hospital of Wuhan University ; Wuhan ; Hubei ; 430071 ; China
  2. Department of Intensive Care Unit ; Zhongnan Hospital of Wuhan University ; Wuhan ; Hubei ; 430071 ; China
  
• 关键词：Total hip arthroplasty ; Bearing surface ; Ceramic ; on ; ceramic ; Metal ; on ; polyethylene ; Meta ; analysis
• 刊名：Journal of Orthopaedic Surgery and Research
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：10
• 期：1
• 全文大小：1,194 KB
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• 刊物主题：Orthopedics; Surgical Orthopedics;
• 出版者：BioMed Central
• ISSN：1749-799X

文摘

Background In recent years, the choice of ceramic-on-ceramic (COC) and metal-on-polyethylene (MOP) in primary total hip arthroplasty (THA) remains controversial. The purpose of this study was to compare the reliability and durability of COC with that of MOP bearing surfaces in THA. Methods Based on prospective randomized controlled trials (RCTs) searched from Pubmed, Embase, Web of Science, and Cochrane central database, we performed a meta-analysis for comparing clinical and radiographic outcomes of COC with those of MOP. Two investigators independently selected studies, extracted data, and assessed risk of bias. Relative risks and weighted mean differences from each trial were pooled using random-effect or fixed-effect models depending on the heterogeneity of the included studies. Results Five RCTs involving 897 patients with 974 hips met predetermined inclusion criteria. Our results demonstrated COC significantly decreased the risks of revision, osteolysis and radiolucent line, aseptic loosening, and dislocation and increased the risks of squeaking and intraoperative implant fracture compared with MOP. There was no significant difference between the two groups in postoperative hip function, deep infection, and heterotopic ossification. Conclusions Generally, despite more squeaking and intraoperative implant fracture, our findings support the use of COC bearing surface which has lower rates of revision, osteolysis and radiolucent line, aseptic loosening, and dislocation compared with MOP.