ArticleBMC musculoskeletal disorders2019
Fourth-generation ceramic-on-ceramic THA results in improvements in midterm outcomes compared to third-generation THA but does not resolve noise problems: a cohort study of a single-hip system.
Article in BMC musculoskeletal disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- 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 · 2021Pooled it
- Comparative outcomes of Forte versus Delta ceramic bearings in total hip arthroplasty using a national database.Scientific reports · 2026Article
- Fourth-generation Ceramic Head Fracture in Total Hip Arthroplasty: A Case Report and Literature Review.Arthroplasty today · 2025Article
- Bony ankylosis adversely affects postoperative hip function in patients with ankylosing spondylitis undergoing total hip arthroplasty: a retrospective cohort study of 319 consecutive patients.BMC musculoskeletal disorders · 2025Article
- May the 4th be with you: mixed-methods best-evidence synthesis on 4th-generation alumina-zirconia ceramic bearings in total hip arthroplasty.EFORT open reviews · 2024Article
- Global mapping of institutional and hospital-based (Level II-IV) arthroplasty registries: a scoping review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Forte ceramic-on-delta ceramic cementless total hip arthroplasty: an 8- to 15-year follow-up study.Archives of orthopaedic and trauma surgery · 2023Article
- A 10- to 12-year follow-up study of delta ceramic-on-ceramic total hip arthroplasty.Archives of orthopaedic and trauma surgery · 2023Article
- Revision total hip arthroplasty by a ceramic bearing surface after a third- and fourth-generation ceramic head or liner fracture.International orthopaedics · 2023Article
- Femoral Nerve Compression due to Adverse Local Tissue Reaction After Ceramic-on-ceramic Total Hip Arthroplasty.Arthroplasty today · 2023Article
- A case-driven hypothesis for multi-stage crack growth mechanism in fourth-generation ceramic head fracture.Journal of orthopaedic surgery and research · 2022Article
- Catastrophic intraoperative failure of a ceramic femoral head.Arthroplasty today · 2021Article
- National Trends in Total Hip Arthroplasty Bearing Surface Usage in Extremely Young Patients Between 2006 and 2016.Arthroplasty today · 2021Article
- Ceramic-on-ceramicWorld journal of orthopedics · 2021Article
- Mid-term outcomes of the R3™ delta ceramic acetabular system in total hip arthroplasty.Journal of orthopaedic surgery and research · 2021Article
- Whole blood titanium metal ion measurement reproducibility of two laboratories.Practical laboratory medicine · 2020Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUsing data from the Korean Hip Registry, we aimed to investigate mid-term clinical and radiographic outcomes, including the prevalence of periprosthetic joint infection (PJI), osteolysis, and component loosening or dislocation, and to analyze the incidence of bearing-related complications following modern ceramic-on-ceramic (COC) total hip arthroplasty (THA) using a single cementless hip system.
methodsFour hundred eighty-two patients (602 hips) who underwent Forte or Delta COC THAs with a single hip system and had a minimum 5-year follow-up were identified. The sample included 243 (50.4%) women and 239 (49.6%) men with a mean age of 50.6 years (range: 18-83 years). The Forte group comprised 310 hips, and the Delta group comprised 292 hips. The mean follow-up was 6.1 years (range: 5-10.2 years).
resultsCup orientation did not differ between groups. No hip had a PJI or osteolysis in either group. All acetabular components and all but two femoral components (in the Delta group) were well fixed. Dislocations occurred in six (1.9%) hips in the Forte group and one (0.3%) hip in the Delta group (p = 0.124). A total of nine (1.5%) revisions were performed. The 5-year survival rates for all-cause revisions were 98.4 and 98.6%, respectively. One (0.3%) ceramic head fracture occurred in the Forte group. Sixteen (5%) hips exhibited clicking and 6 (2%) hips had squeaking in the Forte group; 16 (6%) hips exhibited clicking and 5 (2%) hips had squeaking in the Delta group. Multiple regression analysis revealed that noise generation was unassociated with any factor.
conclusionsFrom the Korean Hip Registry data, THA with modern ceramic bearings showed encouraging results, with lower risks of PJI, osteolysis, and component loosening. In particular, Delta COC THA resulted in no PJI or ceramic fracture and had a reduced dislocation risk. However, associated noise remains a concern.
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