Choosing a Hip Replacement: Ceramic or Metal?Some people spend more time picking out ceramic tile for their bathroom than they do choosing the right hip replacement. Thanks doctors and researchers around the world, we don't have to spend hours and hours figuring out which implant is best.
This study from Austria compares ceramic and metal hip implants. Researchers looked at implant loosening and measured migration of the socket using X-rays. Patients were followed for two years. Hip replacements keep changing as researchers find new and better materials and designs. This makes it hard to compare one type of implant with another over more than a few years at a time.
In this study all patients received the same basic implant design. Some had a socket made of metal; others had one made of polyethylene (a manmade plastic). The ball portion of the hip joint was made of metal for the metal cup and ceramic for the polyethylene cup.
The authors report better results with the metal-on-metal implant. There was less loosening and less movement or migration. These findings were noted at six and 12 months. However, after three years there was no difference in the amount of migration between the two groups.
Migration is one way to tell if the hip implant will fail. The goal is to find a hip implant that doesn't move once it's been put in place. Researchers also want to find an implant that doesn't produce debris (bits of plastic or metal). Debris is also a major factor in joint loosening. When these two issues are addressed, the best hip implant will be obvious. Doctors and patients will be able to spend less time choosing the right implant, and more time thinking about the positive changes after surgery.
C. Pabinger, MD, et al. Migration of Metal-on-Metal Versus Ceramic-on-Polyethylene Hip Prostheses. In Clinical Orthopaedics and Related Research. July 2003. Vol. 412. Pp. 103-110.
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