Topic Ceramic on Ceramic

Executive Summary

3rd generation ceramic-on-ceramic cementless total hip arthroplasty: a minimum 10-year follow-up study

Yeong J. Lau, Shashank Sarmah, Johan D. Witt
Hip Int. 2017 Jul 29:0. doi: 10.5301/hipint.5000541. [Epub ahead of print]
Level of Evidence:
None given. Retrospective analysis.


Lau et al. analyzed their own cementless THA patient cohort with 3rd generation alumina CoC bearings. The aim of the retrospective study was to evaluate the long-term performances of alumina CoC bearings with a particular attention to hip function and noise.

126 primary THA were performed in 108 patients. The mean age at implantation was 39.6 years. The average follow-up was 12.1 years. Clinical and radiographic outcomes were reviewed. The Oxford Hip Questionnaire was completed by all patients investigated.

Kaplan-Meier survivorship calculated at 10 years with revision for any cause as endpoint resulted to be 94.6 %. The mean Oxford Hip Score was 39.8 out of 48. There were no cases of osteolysis, detectable wear or squeaking. 1 patient was revised for early stem subsidence, 1 for deep infection, 2 for recurrent dislocation, 1 for ceramic head fracture with the revision only of the bearing, 1 for progressive radiolucency, probably due to the resorption of the HA-layer on the acetabular cup.

The authors concluded suggesting this articulation for younger patients due to the good preservation of bone quality with no osteolysis.

Study limitations

Key Messages


3rd generation CoC (BIOLOX®forte) bearings confirm the good long-term (> 10 years) clinical outcomes and show good preservation of bone quality without squeaking, osteolysis or wear.

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