Although ceramic implants have been in use for many years and they are intended to minimize wear debris it is unknown whether
alumina-on-alumina or alumina-on-polyethylene produce less wear and osteolysis. We therefore investigated wear and osteolysis
on 28 bilateral arthroplasties (one ceramic-ceramic and the contralateral ceramic-polyethylene) of patients who had survived
20 years without revision and without loosening of either hip. Osteolysis was identified on anteroposterior pelvic radiographs
and 3-D volume from CT scans. The number of osteolytic lesions detected with CT scan was higher than with radiographs. The
number of lesions was higher on the side with the alumina-PE couple. With a similar length of followup on each side, the surface
and the volume of osteolysis were consistently higher on the side with the alumina-PE couple. We found no correlation between
the volume of osteolysis and the volume of estimated wear in each couple of friction. Hips with osteolysis had a lower Harris
score.
Level of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his institution has approved the human protocol for this investigation and that all the investigations
were conducted in conformity with ethical principles of research.