Usefulness of ceramic or metal on metal prostheses in total hip replacement

AUGUSTOVSKI, F; PICHON-RIVIERE A,; ALCARAZ A; BARDACH, ARIEL; FERRANTE, D; GARCIA MARTÍ, SEBASTIAN; GLUJOVSKY, D; LOPEZ, A; REGUEIRO, A; COLANTONIO, LISANDRO

Documentos de Evaluación de Tecnologías Sanitarias

IECS

Año: 2006 p. 1 - 30

1668-2793

This report is intended to assess the use of ceramic or metal on metal prostheses for total hip replacement compared with other existing materials (such as metal and polyethylene).A search on specific electronic databases (MEDLINE, Center for Reviews and Dissemination, LILACS) was performed as well as a global search in several sources to find Technology Evaluations and coverage policies.The clinical trials that compared ceramic against conventional prostheses found no significant differences in the revision rate among the different types of prostheses. In the case series of patients with the ceramic prosthesis analyzed, prosthesis revision rates at 10 years lower than 10% were found, which is considered within acceptable limits and comparable to those reported for conventional prostheses. Similar results were obtained in the search for metal on metal (MoM), where randomised controlled trials (RCTs) with follow-up up to 5 years found no differences in efficiency and complications. Though some patient cohorts have reported an increase in certain hematologic and oncologic pathologies, there ore other reports evaluating the MoM prostheses with follow-up up to 28 years with no increase in the incidence of any cancer. No study comparing ceramic prosthesis with MoM prosthesis was found. At present, some health organizations cover both MoM and ceramic prostheses.