ProsCeramic hip replacements are an attractive new development in orthopedic surgery. The implants address some of the problems with traditional hip replacements. The newest ceramic hip replacement implants do not wear nearly as much as metal and plastic implants. Because the amount of wear of a hip replacement is related to loosening of the implant over time, wear reduction is among the most researched topics in orthopedics.
When a hip replacement loosens, a revision hip replacement may be required. Because revision hip replacements tend to be not as successful as first-time hip replacements, new technology is being developed to prevent loosening.
Ceramic hip replacements look to be a reasonable option for patients who may be at risk for wearing out of the hip implant. Patients who are in their 40s and 50s may benefit from these ceramic hip replacements.
ConsCeramic hip replacement implants have functioned very well in laboratory studies and short-term human investigations. However, they are not perfect, and no one knows how well they work 10, 20, or 30 years after they have been implanted.
One of the most concerning complications of ceramic hip replacements is that they have demonstrated a small rate of so-called 'catastrophic failure.' Because the ceramic hip replacement material is hard and brittle, it can crack, much like a ceramic dish dropped on a tile floor. This used to be more of a problem, and newer ceramic hip replacement implants have been much better. However, the issue of catastrophic failure is still a concern to many physicians.
A ceramic hip replacement can be considered somewhat of an 'educated gamble.' We know that ceramic hip replacements function as though they may be superior to metal and plastic implants, but we do not know that. For most patients, a ceramic hip replacement may not be worth that risk. The metal and plastic implants work perfectly for the vast majority of patients. Ceramic hip replacements probably only warrant consideration is young patients who may develop complications from wearing out of the implant.
Where It StandsThe history of medicine, including orthopedic surgery, is full of 'new developments' that are intended to fix the problems of the past. Some of these work out, some don't. Ceramic hip replacements have been designed to address a common problem in hip replacement surgery: hip implants wear out, especially in younger patients, over time.
The science behind ceramic hip replacements is excellent. The ceramic hip replacement implants have better wear characteristics, and probably will last longer than metal and plastic implants. Unfortunately, some problems with ceramic hip replacements include the issue of catastrophic failure and the lack of long-term use in human studies.
Someday we will know with certainty whether or not ceramic hip replacements are better than metal and plastic implants, but we do not know that now. Some patients, especially younger patients in their 40s and 50s, may elect to undergo a ceramic hip replacement with the hope that these implants will prove to be better.