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Ceramic-on-ceramic (CoC) bearings show promise for revision total hip arthroplasty (THA), offering good functional outcomes and low complication rates. Further prospective studies are needed to confirm their optimal use in revision THA procedures.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Reconstructive Surgery

Background:

  • Ceramic-on-ceramic (CoC) bearings are increasingly used in primary total hip arthroplasty (THA), particularly for young, active patients, due to superior biocompatibility, wear, and lubrication.
  • CoC bearings are less commonly used and analyzed in revision THA procedures.
  • This study systematically reviews the literature on CoC bearings in revision THA.

Purpose of the Study:

  • To systematically review the existing literature on the use and outcomes of ceramic-on-ceramic (CoC) bearings in revision total hip arthroplasty (THA).
  • To evaluate the efficacy and safety of CoC bearings in the context of revision hip surgery.
  • To identify potential indications and limitations of CoC bearings for revision THA.

Main Methods:

  • A systematic literature search was conducted in the English language.
  • Studies reporting on THA revisions using ceramic-on-ceramic bearings were identified.
  • 26 studies, encompassing 1846 procedures, met the eligibility criteria for inclusion in the review.

Main Results:

  • A quantitative synthesis was possible for six studies reporting on CoC bearing THA revisions, with follow-up ranging from 2.1 to 19 years (average 9.3 years).
  • A cumulative weighted mean postoperative Harris Hip Score (HHS) of 87 indicates good functional results.
  • Low complication rates were observed: dislocation at 3.45%, ceramic head fracture at 0.35%, and squeaking at 0.52%.

Conclusions:

  • Ceramic-on-ceramic bearings represent a promising alternative for revision THA, demonstrating favorable outcomes in preclinical and retrospective analyses.
  • Indications include aseptic loosening, recurrent dislocation, ceramic fractures, large defects, or allergies to bone cement components.
  • Prospective or randomized studies are necessary to definitively establish CoC bearings as an optimal solution for revision THA.