Ceramic Hip Replacement Devices
For people who have suffered through years of hip pain and discomfort, hip replacement surgery can change their lives. More than 100,000 hip replacements are performed each year in the United States alone. Hip replacement surgery is highly successful in relieving pain and increasing mobility.
In the past, some artificial hip joints weren’t able to withstand large amounts of stress and strain, and tended to wear down with constant patient activity. Today's versions are sturdier with better wear characteristics, making them suitable for more active people. Several years ago, the Food and Drug Administration (FDA) approved two hip replacement devices (manufactured by the Wright Medical Group and Stryker Corp.), both made of ceramic instead of the traditional metal and high-density polyethylene (a tough plastic). The manufacturers of these devices say they will last longer than traditional hip replacement devices, thereby decreasing the need for follow-up surgeries.
What Is a Hip Replacement?
The hip joint is a “ball and socket” joint in the upper portion of the femur (thigh bone). A diseased hip joint can cause extreme pain and limit mobility. A hip replacement is a surgical procedure that removes the degenerated hip joint and replaces both the ball and socket with artificial parts. The parts are usually anchored in the bone of the thigh and pelvis with bone cement.
Before hip replacement surgery is performed, joint damage is assessed by an x-ray. During the surgery—which usually lasts two to three hours—diseased bone and cartilage is removed from the hip joint. Then, the head of the femur (the ball) and acetabulum (the socket) is replaced with a new, artificial joint, which is designed to allow smooth, gliding motion.
During the days after a hip replacement surgery, it is important to limit the movement of the hip joint. Physical therapy will begin soon after the surgery to strengthen the hip muscles and improve motion. People do not usually spend more than seven days in the hospital after a hip replacement. Full recovery is expected within three to six months, depending upon the extent of the surgery, the health of the person, and the success of the rehabilitation.
Hip replacement is one of the most successful orthopaedic surgeries performed. Adverse effects are rare, but some people may experience a hip dislocation after a hip replacement surgery, and others will have inflammation in the area of the hip joint, which is caused by the particles that wear off the artificial joint. Less common complications include infection, blood clots, and excessive bone growth.
Who Should Get a Hip Replacement?
Conditions such as osteoarthritis, rheumatoid arthritis, inadequate blood supply to the bone, external trauma, and bone tumors can lead to the breakdown of the hip joint. Before a hip replacement is performed, most people will try using non-surgical therapies, including canes and other walking aids, medications, and physical therapy. If these therapies fail to relieve pain and improve mobility in the hip joint, hip replacement surgery may be recommended.
Hip replacement is traditionally performed primarily on older people, but as technology improves and hip replacement devices advance, physicians are recommending it for younger people with hip problems to improve their mobility and allow them to return to their prior activity levels.
People who may not be recommended for a hip replacement are those with Parkinson’s disease and other chronic diseases that result in severe muscle weakness. Also, physicians may not recommend hip replacement for people at high risk for infections, such as people with diabetes, those on steroids, or people who are in poor health thus making them less likely to recover from hip replacement surgery (and other surgeries).
Traditional hip replacement devices, composed of metal and polyethylene, tend to wear out in 12-20 years—which has become problematic in recent times since younger people are having hip replacements and people are living longer and being more active. The new ceramic devices were developed to address this, but researchers will have to wait to determine how long the ceramic models will last. Since the material is smoother than the metal and polyethylene used in traditional devices, the ceramic devices produce less friction with activity, and they may last longer than 20 years.
Ceramic joints, however, aren’t without their limitations. They first appeared in the 1990s, but were recalled by the FDA in 2001 because of higher than expected fracture rates. The most recent devices are made of a type of ceramic that is less likely to fracture. As more ceramic devices are being used, researchers will continue to track their effectiveness over the long term.
If you need to have a hip replacement, your physician now has the option of using a ceramic joint. However, be aware that the majority of total hip replacements being used are the high-density polyethylene and metal types, which have a proven track record. Your surgeon will advise you which type of artificial joint he or she believes is the safest and most effective option for you based upon your age, activity level, and the condition of your hip.
American Academy of Orthopaedic Surgeons
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Questions and answers about hip replacement. National Institute of Arthritis and Musculoskeletal and Skin Diseases. National Institutes of Health website. Available at: http://www.niams.nih.gov/hi/topics/hip/hiprepqa.htm. Accessed July 16, 2003.
Osteonics ABC system and Trident system . Publication P000013. Food and Drug Administration website. Available at: http://www.fda.gov/cdrh/mda/docs/p000013.html. Accessed July 15, 2003.
Ceramic TRANSCEND hip articulation system. Publication P010001. Food and Drug Administration website. Available at: http://www.fda.gov/cdrh/mda/docs/p010001.html. Accessed July 15, 2003.
Last reviewed April 2008 by Robert E. Leach, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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