What’s In That Joint?

When pain is experienced from hip osteoarthritis, and continues to persist with regular activities of daily living (ADL), a total joint replacement (TJR) may be the most effective option. A total hip replacement is a common surgery that is performed with high reported levels of success for patients, post-operation. In the past, TJR surgery for the hip involved different types of materials, including metal-on-metal implants. However, these metal-on-metal materials often led to poor health outcomes post-surgery, and newer total hip replacement surgeries rely on updated materials, such as ceramic-on-ceramic and ceramic-on-plastic.

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Limitations with metal-on-metal bearings

Early total hip arthroplasty surgeries primarily used metal-on-metal bearings. However, patients tended to report higher levels of impingement at the hip. The use of metal-on-metal materials in total hip replacements has also led to corrosion of the bearings and loss of surface area for patients over time. Due to the higher levels of reported complications, metal-on-metal hip replacement surgeries should be carefully monitored by a healthcare professional.

Trending towards ceramic-on-ceramic

Over time, ceramic-on-ceramic materials have become a popular option for total hip replacement procedures. With lower friction rates and reports of less wear over time, use of ceramic-on-ceramic bearings has increased over time. Based on a recent systematic review, researchers discovered that patients under 60 showed high levels of survivorship with ceramic-on-ceramic materials, when compared to a previous meta-analysis performed a decade earlier. The study notes that participants experienced less rates of aseptic loosening, ceramic fractures, and squeaking, along with higher levels of survivorship overall.

More opt for ceramic-on-polyethylene bearings

While ceramic-on-ceramic bearings have been commonly used, a limitation includes the brittleness of ceramic, and possible outcomes related to fractures have been recorded. In a recent study, researchers found that patients with ceramic-on-polyethylene reported better clinical outcomes after a long-term follow up, when compared to a group of patients who received ceramic-on-ceramic materials from their total hip arthroplasty. After 13 years, researchers compared outcomes between patients with ceramic-on-polyethylene and ceramic-on-ceramic bearings, and found that ceramic-on-polyethylene led to higher health outcomes.

Why choosing TJR implant material matters

Hip osteoarthritis can have a detrimental effect on ADL. Based on levels of clinical outcomes and satisfaction of patients, total hip replacement surgeries are noted to be one of the most successful types of procedures. Total hip replacement is often chosen as a means to decrease levels of pain with movement, to reduce limitations, and to help improve quality of life. Metal-on-metal bearings were an earlier option for total hip replacement surgeries, newer procedures opt for ceramic-on-ceramic or ceramic-on-polyethylene bearings. For those considering a joint replacement at the hip, remember to consider the type of implant material in regards to higher clinical outcomes post-surgery. As new technological developments arise, implementation of other bearings may be used in future joint replacement surgeries along the horizon.