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EBRA migration patterns of the Plasmacup with ceramic or polyethylene inserts: a randomised study.

U Ochs¹, T Ilchmann, B G Ochs

¹BG Trauma Centre, University of Tuebingen, Schnarrenbergstrasse 95, Tuebingen, Germany. uochs@bgu-tuebingen.de

Zeitschrift Fur Orthopadie Und Unfallchirurgie

|November 21, 2007

Summary

This study compared ceramic-ceramic and ceramic-polyethylene bearings in total hip arthroplasty. Both bearing types demonstrated similar mid-term outcomes, suggesting continued use is appropriate.

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Area of Science:

Orthopedic Surgery
Biomaterials Science
Medical Engineering

Background:

Total hip arthroplasty (THA) aims to restore joint function and patient quality of life.
Bearing material selection is crucial for longevity, influencing wear and loosening rates.
Aseptic loosening remains a significant concern in THA, often linked to wear debris.

Purpose of the Study:

To evaluate the influence of ceramic-ceramic versus ceramic-polyethylene bearings on implant migration and wear.
To assess the mid-term effects of these bearing materials on artificial joint function and patient outcomes.
To provide evidence-based recommendations for bearing material selection in THA to minimize wear and aseptic loosening.

Main Methods:

Prospective randomized study involving 66 patients undergoing cementless THA with Bicontact stem and Plasmacup.
Patients were randomized to receive either ceramic-ceramic (n=35) or ceramic-polyethylene (n=31) bearings.
Clinical and radiological assessments included Harris Hip Score, Hannover function questionnaire, and EBRA at a mean follow-up of 8.1 years.

Main Results:

A 65.2% follow-up rate was achieved over a mean of 8.1 years.
No significant differences in clinical or radiological parameters were observed between the ceramic-ceramic and ceramic-polyethylene groups.
Slight, transient subsidence of the Plasmacup was noted in 6.1% of cases, independent of bearing material.

Conclusions:

The press-fit cup fixation demonstrated excellent stability, confirming its efficacy.
Both ceramic-ceramic and ceramic-polyethylene bearings show comparable mid-term results in THA.
Long-term studies are necessary to definitively differentiate wear and migration behavior between the two bearing types.