Alumina ceramic bearings for total hip arthroplasty: five-year results of a prospective randomized study

Clin Orthop Relat Res. 2005 Jul;(436):164-71.


Three hundred twenty-eight ceramic bearings were implanted by six surgeons in 316 patients as a part of a prospective randomized US Investigational Device Exemption study comparing alumina ceramic bearings with cobalt chrome-on-polyethylene bearings. There was no difference between the control metal-on-polyethylene and the alumina bearing couple patient cohorts regarding demographics or clinical scores through 7 years. Revision for any reason occurred in 2.7% of the patients with alumina bearings and 7.5% of the control patients with polyethylene bearings. Osteolysis was found in 1.4% of the patients with alumina bearings and in 14.0% of the control patients. At an average followup of 5.0 years (range, 1-86 months) no ceramic fractures or ceramic bearing failures have occurred. Results of this study suggest that alumina ceramics perform as well as the metal-on-polyethylene in clinical scores, but the patients with ceramic bearings had fewer revisions and less osteolysis. These results lead us to think that this new alumina ceramic bearing provides a safe option for younger and more active patients.

Level of evidence: Therapeutic study, Level I-1b (randomized controlled trial, no significant difference, but narrow confidence intervals). See the Guidelines for Authors for a complete description of levels of evidence.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aluminum Oxide*
  • Arthroplasty, Replacement, Hip / adverse effects
  • Arthroplasty, Replacement, Hip / instrumentation*
  • Arthroplasty, Replacement, Hip / methods
  • Chromium
  • Cobalt
  • Evidence-Based Medicine
  • Female
  • Follow-Up Studies
  • Hip Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis, Hip / diagnostic imaging
  • Osteoarthritis, Hip / surgery
  • Osteolysis / epidemiology
  • Osteolysis / etiology
  • Polyethylene
  • Postoperative Complications
  • Prospective Studies
  • Prosthesis Design
  • Radiography
  • Reoperation
  • Treatment Outcome


  • Chromium
  • Cobalt
  • Polyethylene
  • Aluminum Oxide