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Meta-Analysis
. 2015 Feb 3:10:22.
doi: 10.1186/s13018-015-0163-2.

Comparison of ceramic-on-ceramic to metal-on-polyethylene bearing surfaces in total hip arthroplasty: a meta-analysis of randomized controlled trials

Dongcai Hu  1 , Kai Tie  2 , Xiao Yang  3 , Yang Tan  4 , Mohammed Alaidaros  5 , Liaobin Chen  6
Affiliations
Meta-Analysis

Comparison of ceramic-on-ceramic to metal-on-polyethylene bearing surfaces in total hip arthroplasty: a meta-analysis of randomized controlled trials

Dongcai Hu et al. J Orthop Surg Res. .

Abstract

Background: In recent years, the choice of ceramic-on-ceramic (COC) and metal-on-polyethylene (MOP) in primary total hip arthroplasty (THA) remains controversial. The purpose of this study was to compare the reliability and durability of COC with that of MOP bearing surfaces in THA.

Methods: Based on prospective randomized controlled trials (RCTs) searched from Pubmed, Embase, Web of Science, and Cochrane central database, we performed a meta-analysis for comparing clinical and radiographic outcomes of COC with those of MOP. Two investigators independently selected studies, extracted data, and assessed risk of bias. Relative risks and weighted mean differences from each trial were pooled using random-effect or fixed-effect models depending on the heterogeneity of the included studies.

Results: Five RCTs involving 897 patients with 974 hips met predetermined inclusion criteria. Our results demonstrated COC significantly decreased the risks of revision, osteolysis and radiolucent line, aseptic loosening, and dislocation and increased the risks of squeaking and intraoperative implant fracture compared with MOP. There was no significant difference between the two groups in postoperative hip function, deep infection, and heterotopic ossification.

Conclusions: Generally, despite more squeaking and intraoperative implant fracture, our findings support the use of COC bearing surface which has lower rates of revision, osteolysis and radiolucent line, aseptic loosening, and dislocation compared with MOP.

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Figures

Figure 1
Figure 1
A flowchart shows the selection of studies for inclusion in the meta-analysis. COC ceramic-on-ceramic, MOP metal-on-polyethylene, RCT randomized controlled trial.
Figure 2
Figure 2
Forest plot for meta-analysis of Harris hip score. COC ceramic-on-ceramic, MOP metal-on-polyethylene.
Figure 3
Figure 3
Forest plot for meta-analysis of revision. COC ceramic-on-ceramic, MOP metal-on-polyethylene.
Figure 4
Figure 4
Forest plot for meta-analysis of osteolysis and radiolucent line. COC ceramic-on-ceramic, MOP metal-on-polyethylene.
Figure 5
Figure 5
Forest plot for meta-analysis of aseptic loosening. COC ceramic-on-ceramic, MOP metal-on-polyethylene.
Figure 6
Figure 6
Forest plot for meta-analysis of squeaking. COC ceramic-on-ceramic, MOP metal-on-polyethylene.
Figure 7
Figure 7
Forest plot for meta-analysis of implant fracture. COC ceramic-on-ceramic, MOP metal-on-polyethylene.
Figure 8
Figure 8
Forest plot for meta-analysis of dislocation. COC ceramic-on-ceramic, MOP metal-on-polyethylene.
See this image and copyright information in PMC

References

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