Ceramic-on-Ceramic Versus Ceramic-on-Polyethylene Bearing Surfaces in Total Hip Arthroplasty

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Nine randomized controlled trials were included in this meta-analysis comparing revision and complication rates between ceramic-on-ceramic and ceramic-on-polyethylene total hip arthroplasty. Meta-analyses demonstrated no significant differences between the surface bearing types in revision rate, or incidences of complications such as osteolysis, component loosening, infection, heterotopic ossification, bursitis, or leg-length discrepancy. Ceramic-on-ceramic articulation was observed to significantly increase the risk of implant fracture, as well as the incidence of component squeaking, when compared to ceramic-on-polyethylene surfaces.