Metasul vs Cerasul bearings: a prospective, randomized study at a mean eighteen years
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ORIGINAL PAPER
Metasul vs Cerasul bearings: a prospective, randomized study at a mean eighteen years Quentin Andeol 1 & Anthony Viste 1,2
&
Romain Desmarchelier 1 & Jean-Luc Lerat 1 & Michel-Henri Fessy 1,2
Received: 8 September 2020 / Accepted: 15 October 2020 # SICOT aisbl 2020
Abstract Background The aims of our study were to compare the clinical, radiographic outcomes and survivals between secondgeneration metal-on-metal (Metasul) and ceramic-on-ceramic (Cerasul) bearings at a very long-term follow-up. Methods A prospective, randomized study was originally performed on a consecutive series of 250 cementless, 28-mm head and primary total hip arthroplasties between 1999 and 2002. For each bearing (Metasul or Cerasul), 125 THAs were initially included. All cases were evaluated both clinically and radiographically, and survival was assessed, considering revisions for aseptic loosening or for any reason as the end points for failure. Results At a mean 18-year follow-up, clinical and radiographic outcomes were similar. Harris Hip Score increased 30% in the Metasul group and 32% in the Cerasul group (p = 0.6). Survival free of aseptic loosening was higher for Cerasul (100%), than for Metasul (94% [CI 88–99.9]) (p = 0.04). Survival free of any revision was 91% ([CI 84–98%]) for Cerasul and 91% ([CI 84– 98%]) for Metasul. Fractures of Cerasul insert occurred in four cases (3%) at a mean 12.5 ± 3.3 years (range, 6 to 17 years). Conclusion At 18 years, Cerasul demonstrated higher survivorship than Metasul considering aseptic loosening as an end point. However, Cerasul liners had high rate of fracture because of its sandwich design (thin ceramic liner into polyethylene). These implants are no more available on the market. Keywords Metal-on-metal . Ceramic-on-ceramic . Bearings . Total hip arthroplasty . Survival . Randomized trial
Introduction Metal-on-metal bearing (MoM) was introduced in the 1960s, by McKee and Watson-Farrar [1, 2]. At the same period,
* Anthony Viste [email protected] Quentin Andeol [email protected] Romain Desmarchelier [email protected] Jean-Luc Lerat [email protected] Michel-Henri Fessy [email protected] 1
Hospices Civils de Lyon, Hôpital Lyon Sud, Service de Chirurgie Orthopédique et Traumatologique, 165 Chemin du Grand Revoyet, 69495 Pierre Bénite Cedex, France
2
Univ de Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMRT_9406, Lyon, France
Charnley et al. [3] developed the concept of low friction arthroplasty using a metal-on-polyethylene bearing (MoP) couple that yielded excellent functional results with a very good survival rate [3]. In the 1970s, Boutin et al. [4] developed another bearing couple using ceramic-on-ceramic (CoC). After 25 years of clinical use of MoP bearings, a new disease appeared: the so-called particle disease, a biologic reaction that occurred in response to the release of small particles (PE wear debris) that led to aseptic loosening [5]. Therefore, there was a new interest in metal-on-metal (MoM) and Co
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