Metal versus Ceramic Hip Replacementgreenspun.com : LUSENET : About Joints : One Thread
My father-in-law is considering a hip replacement and the doctor has said he could select either a Metal-Metal or Ceramic-Ceramic product.
I have been researching the entire web, but cannot find anything that givs me the Pros/Cons of each system, does anyone know if this data is available anywhere?
Also, would like to know about the Pros/Cons for Cemented, Cementless or Hybrid - some doctors say 1 thing and others say another.!!!
-- Ken Le Gall (email@example.com), May 09, 2003
Hello Ken: Excellent question. I am also a candidate for THR, and have been searching for the same information. Some kind of comparison or discussion about the differences between all of the options.
-- Val H (firstname.lastname@example.org), May 17, 2003.
I have been doing research on the metal on metal hip replacements & the different types for my 50 yr old husband for the past 6 months. There is the Wright Medical Tech website they maufacture a metal on metal hip called the Conserve, also the Biomet Co. There are many many websites that I have found by just entering, metal on metal hip replacements, or hip replacements, many of them will give you lots of info on the difference in types. I have learned that some they cement some have a porus surface that your bone will grow into The big problem that I have found is trying to find a local doctor that does the metal on metal so that we can discuss his options. Good Luck
-- susie barber (JBANDILA@AOL.COM), August 03, 2003.
Hi Ken! My name is Rebekah. In about a month or so I will be having a metal on metal THR! It sounds better than the ceramic hip by far! The ceramic hip, little pieces break off and it will ware faster than the metal on metal. With the metal on metal, they say that it can last up til a life time. It takes longer for it to ware, almost impossible. So I recomend the metal on metal. I will let you know how the surgery goes. Please email me back, Im very interested. Thanks
-- Rebekah (email@example.com), August 21, 2003.
Just got a ceramic by stryker Aug.15th. I am healing well but since I have uncemented device I still can't put weight on joint. Metal on metal hips look good but still wear faster than ceramic. Ceramic got a bad rap early on but the failures were not the fault of the material but from design and installation problems. Clinical studies on newer generation ceramic devices are very good. There is also an issue of metal particualate and what the long term result of this exposure might be in the metal joints. Just look out on the net under ceramic hip and you will find a lot of info. Good luck. Mike
-- mike (firstname.lastname@example.org), September 09, 2003.
My husband is suppose to have a hip replacement done nect month, can anyone give me any further information regarding metal vs. ceramic.
-- Nicole Niles (email@example.com), September 23, 2003.
I just got Revision hip done on me 2 weeks ago. I am back to work and doing OK. My doctor tried to put metal on Metal and was not successful. Metal on Metal are good on the virgin hip. Ceramic should last long time too but I would still prefer Metal on Metal. I first hip failed in less then 8 years and I am 36 now. Good luck
-- Syed Moizuddin (firstname.lastname@example.org), October 14, 2003.
My 34 year old husband is having THR the day before Thanksgiving. Dr. says that he has used metal-metal on alot of his younger patients (my hubby is the youngest) Dr. says that he has had really good luck using this joint, says that his patients have recovered well and that they have even gone back to playing tennis and last week he went paint balling with one of them. I have read that the metal to metal lasts much longer. Here is to hoping that they are correct!!!
-- LeeAnne Krug (email@example.com), November 18, 2003.
There seems to be no definitive answer on which will wear longer. M on M or ceramic on ceramic. Dr. Gary Hess in Denver who does only hip and knee replacements wants to do "Stryker ceramic" on me Dec 10. Does anyone have good info on the best Doctor and best material to use. I have also heard about a larger "ball" that makes dislocation less likely. I am very athletic, 53 yrs. old, and want to get back to an active lifestyle. I figure I have only one shot at getting it right.
-- Steve Bigelow (firstname.lastname@example.org), December 01, 2003.
Hi...I had a metal on metal left hip replacement done November 24th and am doing great. I am 53 and very active (horseback riding,etc) and wanted the best. My doctor is one of the best in the country and would not do the ceramic on ceramic since it has not proven itself yet...It has barely been 4 weeks and I am amazed how well I am feeling....I still use a walker since my doctor does not permit full weight baring for 6 weeks..I do still have some surgical pain and stiffness...but it is less day by day....The manufacturer was BioTec...I trusted my doctos knowledge and reputation and it was one of the best decisions I had ever made...Good Luck... Take care...Sharen
-- Sharen (email@example.com), December 21, 2003.
I am a ceramic engineer and partial to ceramic products, but not sure about the ceramic/ceramic configuration.
My first THR was 10 years ago (age 52). This was ceramic (zirconium oxide)ball and UHDPE (ultra high density polyethylene)cup. The research at the time showed ceramic to have about 1/10th the wear on the UHDPE as metal balls. This is important as the UHDPE will be the only part that wears out. This lower wear relates to a smoother surface achievable with the ceramic due to the finer grain structure and corrosion resistance of ceramic vs metal. My second hip was installed 4 years ago with the same configuration as the Ceramic/Ceramic was just being tested at the time. Both hips doing well. In the intervening 6 years between the two THR, significant improvements in the UHDPE had been made.
Both used HA (hydroxyl appetite) or calcium phosphate coated stems. Calcium phosphate is very close to bone in composition and encourages bone growth on the surface. The other coating used in cement less THR is a porous metal surface.
The only problem with the first THR was that the stem rigidity vs the bone and resulted in low level thigh pain for 2 years until the bone strengthened. The doc used a split stem (like a close pin) that had a flex similar to bone for the second THR.
My wife is up for a THR next month and she will use the same configuration. The only difference is that she found a doc that uses MIS (minimally invasive surgery) techniques. She will have a 2 -3" inch scare vs about 10". This means much less soft tissue damage and much faster recovery. I think anyone who has had THR will recommend MIS in a heart beat
-- Jerry Spieckerman (firstname.lastname@example.org), December 30, 2003.
I'm 52. As a former professional (tennis), I have put off my total hip for years while ingesting all the info I could. Ceramic on cross- linked poly (plastic) is very good. It gives off less molecules during wear which causes loosening. Ceramic on Ceramic will last very long but there is a slight chance of breakage which causes a difficult revision. Metal on Metal will last forever and does not give off any molecules (loosening) and is the choice of the young and active...unfortunately they do give off metal ions which possibly has a cancer link. The small incision is great if your guy knows what he is doing. You don't want to trade in a smaller cut for an incorrect angle or uneven leg length...Good luck to us all !
-- john miceli (email@example.com), January 20, 2004.
I am 53 and had left THR on March 16, 2004 and came home from the Hospital virtually painfree on March 18! I can't believe how well I'm feeling thus far. My advice to anyone considering this procedure is to do your own research and after doing so, choose a surgeon who has a solid reputation and experience in all the different types of procedures and materials available. Based on my surgeon's recommendation, I had the cementless ceramic on ceramic prosthesis manufactured by Stryker. I had done alot of research and mainly because of my age, I was hoping the ceramic/ceramic was going to be his recommendation. I know the ceramic has only been FDA approved since February, 2003 so the jury is still out on how well it will do in the body, but based on ceramic performing so well in laboratory simulations (200 times longer life than metal & plastic)I was willing to take the chance. My basis for this is based on living a normal life expectancy, the best case scenario is it will perform well and I will never need a revision. The worst case is that it will not perform well and I will need a revision, which I would need at least one revision and possibly more with the metal/plastic prosthesis. Also, my surgeon would not perform metal on metal as he says the data coming out pertaining to the metal ion release and it's potential link with tumors and cancer is not worth the risk. I'm not saying this is the right choice for everyone, but feel comfortable that it was the right choice for my situation. Best wishes as you go thru the process of determining what is best for you!
-- Norm Van Roekel (firstname.lastname@example.org), March 19, 2004.
I think that every operation should be taylored to the individual. There are pros and cons in every case. I have recently (3 weeks ago) been given a ceramic on ceramic non-cemented hip. Ceramic is one of the hardest substances known to man, so it will not easily wear away, nor chip off. The notion of something chipping off is more likely where cement is used, it's the cement itself that may break away. My surgeon decided that this would be the best for me as I am relatively young at 50, and still active. I am not sure how things work in the USA, but here I had little choice, and bowed to the superior knowledge of a trained surgeon. But having said that, I am more than happy to trust that he knows more than I do about the whole thing. I have been given lots of restrictions to 'obey' for the next few weeks. Partial weight bearing for 6 weeks, an using raised toilet seats etc. Again, he's the expert, and I want this to really last for me. So far so good, even if I am a wee bit sick of day-time TV and the same 4 walls. But soon, watch this space, I'll be out there giving it 100% again! Good luck to you all. Lin.
-- Lin Ellis (email@example.com), March 31, 2004.
Ken, Having read most of the above inputs, I think that most of them are correct. I think that the person to ask in most of these situations is a surgeon, they can give you all the pros and cons of what one does vs. the other. I have done some research of my own and with my surgeons help we have choosen to go with metal on metal. There are always some small things that one can offer that the other cannot. My surgeon has informed me that metal on metal in my situation will allow me with about a 9% greater rotation in my hip joint. I was born with Hip displaysa which as greatly deteriorated my hip joint. I am scheduled to have my surgery done on November 8th. After walking with a horably noticible limp for 39 years, I cannot wait to see what it is like to walk normal and pain free. Good luck on your research and the best of luck to your father in law. Gregg Keating
-- Gregg Keating (firstname.lastname@example.org), September 21, 2004.
i think it's interesting that there is so little objective information about which type of prosthesis is best. looking at this forum really raisies the question of why can't there be a consensus among surgeons. how much of the so called research is being compiled by the individual implant companies in hopes of touting their product? i had a cementless ceramic on ceramic right hip placed 5 weeks ago. i walked out of the hospital with a cane 3 days later. my surgeon said "weight bearing as tolerated". i see a lot of people on this site saying no total weight bearing with cementless hips for about 6 weeks. i also see a lot of conflicting information about post op motion restrictions and duration. i have a fair amount of pain, especially at night (sleep is difficult without vicodin), but i'm back at work where i sit and lean forward @ 90 degrees + with no problem. yes, you have to trust your surgeon, but who do they trust and how do they make their decisions?
-- mark dibona (email@example.com), October 19, 2004.