Ten-year survival of ceramic-on-ceramic total hip arthroplasty in patients younger than 60 years: a systematic review and meta-analysis

Abstract Background Total hip arthroplasty (THA) with ceramic-on-ceramic (CoC) was created to minimise wear debris and aseptic loosening. A decade ago, a meta-analysis showed a 10-year survival rate of just 89%. Based on the excellent tribology of the current CoC, significant improvement of implant...

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Main Authors: Ihab Ibraheam El-Desouky, Albaraa Hassan Helal, Ali Mohamed Reda Mansour
Format: Article
Language:English
Published: BMC 2021-11-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-021-02828-1
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author Ihab Ibraheam El-Desouky
Albaraa Hassan Helal
Ali Mohamed Reda Mansour
author_facet Ihab Ibraheam El-Desouky
Albaraa Hassan Helal
Ali Mohamed Reda Mansour
author_sort Ihab Ibraheam El-Desouky
collection DOAJ
description Abstract Background Total hip arthroplasty (THA) with ceramic-on-ceramic (CoC) was created to minimise wear debris and aseptic loosening. A decade ago, a meta-analysis showed a 10-year survival rate of just 89%. Based on the excellent tribology of the current CoC, significant improvement of implant survivorship is expected. In patients younger than 60, we conducted a meta-analysis to assess 10-year survival and complications after using current primary CoC THA. Materials and methods PubMed, Scopus, EMBASE, Virtual Health Library, and Cochrane Library were used to scan for published trials that met the inclusion criteria until January 2019. The qualified studies were subjected to a systematic review and proportional analysis, and the randomised controlled trials (RCTs) were included in a comparison meta-analysis. Results Thirteen studies were included 156 findings. The total number of hips was 2278. Nine studies were cohort, and four were RCTs between ceramic and polyethylene cups. The analysis revealed an average age of 44 years (range 24–54). The 10-year survival 96% (95% CI; 95.4–96.8%), aseptic loosening rate 0.516. (95% CI; 0.265–0.903), ceramic fracture rate 0.620 (95% CI; 0.34–1.034) and squeaking rate 2.687 (95% CI; 1.279–4.593). A comparison meta-analysis revealed the risk ratio (RR) for revision was 0.27 (95% CI; 0.15–0.47), and for aseptic loosening 0.15 (0.03–0.70) favouring CoC, while RR for component fracture was 1.62 (95% CI; 0.27–9.66) favouring the polyethylene. Conclusion In patients under sixty, current CoC THAs are correlated with better 10-year outcomes than before and have high survivorship rates. Level of evidence: Level I.
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spelling doaj.art-bfcbd6b8637b42f8b30f2f2f6e1097d22022-12-22T03:58:57ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-11-011611910.1186/s13018-021-02828-1Ten-year survival of ceramic-on-ceramic total hip arthroplasty in patients younger than 60 years: a systematic review and meta-analysisIhab Ibraheam El-Desouky0Albaraa Hassan Helal1Ali Mohamed Reda Mansour2Faculty of Medicine, Kasr Alainy School of Medicine, Cairo UniversityFaculty of Medicine, 6th Oct. UniversityFaculty of Medicine, Kasr Alainy School of Medicine, Cairo UniversityAbstract Background Total hip arthroplasty (THA) with ceramic-on-ceramic (CoC) was created to minimise wear debris and aseptic loosening. A decade ago, a meta-analysis showed a 10-year survival rate of just 89%. Based on the excellent tribology of the current CoC, significant improvement of implant survivorship is expected. In patients younger than 60, we conducted a meta-analysis to assess 10-year survival and complications after using current primary CoC THA. Materials and methods PubMed, Scopus, EMBASE, Virtual Health Library, and Cochrane Library were used to scan for published trials that met the inclusion criteria until January 2019. The qualified studies were subjected to a systematic review and proportional analysis, and the randomised controlled trials (RCTs) were included in a comparison meta-analysis. Results Thirteen studies were included 156 findings. The total number of hips was 2278. Nine studies were cohort, and four were RCTs between ceramic and polyethylene cups. The analysis revealed an average age of 44 years (range 24–54). The 10-year survival 96% (95% CI; 95.4–96.8%), aseptic loosening rate 0.516. (95% CI; 0.265–0.903), ceramic fracture rate 0.620 (95% CI; 0.34–1.034) and squeaking rate 2.687 (95% CI; 1.279–4.593). A comparison meta-analysis revealed the risk ratio (RR) for revision was 0.27 (95% CI; 0.15–0.47), and for aseptic loosening 0.15 (0.03–0.70) favouring CoC, while RR for component fracture was 1.62 (95% CI; 0.27–9.66) favouring the polyethylene. Conclusion In patients under sixty, current CoC THAs are correlated with better 10-year outcomes than before and have high survivorship rates. Level of evidence: Level I.https://doi.org/10.1186/s13018-021-02828-1CeramicArthroplastyHipNon-elderly
spellingShingle Ihab Ibraheam El-Desouky
Albaraa Hassan Helal
Ali Mohamed Reda Mansour
Ten-year survival of ceramic-on-ceramic total hip arthroplasty in patients younger than 60 years: a systematic review and meta-analysis
Journal of Orthopaedic Surgery and Research
Ceramic
Arthroplasty
Hip
Non-elderly
title Ten-year survival of ceramic-on-ceramic total hip arthroplasty in patients younger than 60 years: a systematic review and meta-analysis
title_full Ten-year survival of ceramic-on-ceramic total hip arthroplasty in patients younger than 60 years: a systematic review and meta-analysis
title_fullStr Ten-year survival of ceramic-on-ceramic total hip arthroplasty in patients younger than 60 years: a systematic review and meta-analysis
title_full_unstemmed Ten-year survival of ceramic-on-ceramic total hip arthroplasty in patients younger than 60 years: a systematic review and meta-analysis
title_short Ten-year survival of ceramic-on-ceramic total hip arthroplasty in patients younger than 60 years: a systematic review and meta-analysis
title_sort ten year survival of ceramic on ceramic total hip arthroplasty in patients younger than 60 years a systematic review and meta analysis
topic Ceramic
Arthroplasty
Hip
Non-elderly
url https://doi.org/10.1186/s13018-021-02828-1
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AT albaraahassanhelal tenyearsurvivalofceramiconceramictotalhiparthroplastyinpatientsyoungerthan60yearsasystematicreviewandmetaanalysis
AT alimohamedredamansour tenyearsurvivalofceramiconceramictotalhiparthroplastyinpatientsyoungerthan60yearsasystematicreviewandmetaanalysis