Facts About Ceramic Hip Replacements

Surgical options expand as patients get ever younger

Orthopaedic surgeon and nurse with replacement hip stem
Getty Images/Monty Rakusen

Total hip replacement surgery is among the most successful procedures performed by orthopedic surgeons. They provide both immediate and long-term relief to persons suffering severe ​hip arthritis, hip osteonecrosis, or other complex hip problems. Over 90 percent of those who have undergone the surgery report major pain relief and an improved ability to perform routine activities.

Moreover, around 80 percent will have a fully functioning device after 20 years.

Hip Replacement Use Is Steadily Changing

Because of the success of hip replacement surgery, the procedure is now being performed in younger patients. The problem with this, of course, is that hip replacements wear out over time. Currently, the average hip replacement lasts around 25 years. In younger, more active people, the deterioration may be far quicker.

And this could be a real problem. At present, revision hip replacement is a far more complicated, and the results are not often as good. Faced with this reality, orthopedists will usually make every effort to delay replacement until an age where the implant is more likely to last the remainder of one's lifetime.

But sometimes delaying is not possible. As a result, researchers are constantly exploring new technologies that may provide the same level of relief while extending the lifetime utility of these invaluable devices.

Advent of Ceramic Hip Implants

Ceramic hip implants are among the newer types of prostheses being used for hip replacement, offering greater resistant to damage and smooth movement of the joint.

Many surgeons today consider them to be an improvement over traditional metal-and-plastic implants in which the deterioration of plastic can lead to the gradual buildup of debris around the joint. This can trigger an immune response that leads to inflammation and the development of benign cysts known as pseudotumors.

Over time, these events can gradually loosen of the implant and cause premature failure.

Ceramic devices, by contrast, appear to cause far less inflammation and few, if any, pseudotumors. This appears true whether the device is all-ceramic, ceramic-and-metal, or ceramic-and-plastic.

While it may seem reasonable to suggest that these benefits translate to longer, problem-free use, we can really only assume that at this stage. With little long-term evidence yet to support these claims, all we can really do is examine what we know for a fact.

What the Current Research Tells Us

Research conducted in 2015 reviewed five high-qualities studies investigating the clinical outcome of persons receiving an all-ceramic hip implant. In total, 897 patients were included. The mean duration of the combined studies was 8.4 years, while the mean age of the participants was 54.5 years.

Based on the analysis, the investigators were able to conclude that the persons offered an all-ceramic implant had lower rates of revision surgery, bone deterioration, and the loosening and/or dislocation of the device compared to metal-and-plastic implants.

The two major drawbacks, by comparison, were a greater likelihood of squeaking and a higher risk of damage to the device during the operation (such as cracks or chips caused when the device was accidentally dropped).

In addition, there is a small risk of a so-called "catastrophic failure," wherein a serious fall or impact could potentially shatter the ceramic.  Fortunately, newer composites have proven far more resilient and impact-resistant than earlier generation ceramics.

A Word From Verywell

No matter how effective or popular the procedure has become, a total hip replacement should always be regarded a major surgery and should only be embarked upon with a full understanding of both the benefits of surgery and the possible consequences.

While a ceramic hip implant certainly appears a more attractive option for younger people, only consider one after lengthy consultation with an orthopedic specialist and after all other treatment options have been exhausted.

Source:

Hu, D.; Tie, K.; Yang, X. et al. "Comparison of ceramic-on-ceramic to metal-on-polyethylene bearing surfaces in total hip arthroplasty: a meta-analysis of randomized controlled trials." J Orthop Surg Res. 2015; 10:22.

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