Observational studyArchives of orthopaedic and trauma surgery2025
Outcomes following primary total hip arthroplasty with ceramic-on-metal and metal-on-metal bearings.
Observational study in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Long-term Performance and Durability of Biomaterials and Implant Designs in Total Joint Arthroplasty and Spinal Fusion.Journal of orthopaedics and sports medicine · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThere is concern in the scientific community that patients implanted years ago with metal-on-metal (M-M) bearings for total hip arthroplasty (THA) may still have persistent and potentially toxic levels of chromium (Cr) and cobalt (Co). Studies suggest that blood metal levels may be elevated in both ceramic-on-metal (C-M) and M-M bearings. The objective of this study was to establish whether patients with THA and C-M bearing surfaces require the same follow-up as those with M-M THA and to evaluate the long-term survival of THAs with M-M and C-M bearing surfaces, blood Cr and Co levels and complications (especially metallosis). MATERIALS AND
methodsA retrospective, observational, analytical, descriptive cohort study was conducted on the patients who underwent THA at a single centre with the use of M-M (64) and C-M (76) bearings and a control group (44 THA: 23 ceramic-on-ceramic, 8 metal-on-polyethylene, 13 ceramic-on-polyethylene) between 2005 and 2009 (an additional 12 THAs performed with the same implants between 2010 and 2012 were also included). The median follow-up period was 14.41 (interquartile range 11.6-15.7) years. The primary outcomes were blood levels of Cr and Co, complications, implant survival and patient survival (Kaplan Meier analysis). Multivariate binary logistic regression was performed to examine the risk of metallosis, prosthesis replacement and death between groups, adjusting for potential confounders.
resultsTHA with M-M bearings produce more metallosis (47%, p < 0.001) than C-M bearings (16%). Thirty-one THA revisions were performed (17%), with significantly more revisions in the M-M group (33%) compared to both the C-M group (11%, p = 0.002) and the control group (4%, p = 0.003). There were no significant differences in 15-year patient survival between the groups.
conclusionsRoutine monitoring of C-M bearings should be recommended, similar to the protocols for M-M. In the long term, both metallosis and revision rates are unacceptably high for both types of bearings, with M-M bearings performing worse. Therefore, neither implant type is recommended for THA.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.