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News, Trends, and Insights from the World of Hip and Knee Replacement and Beyond

Read up on the research transforming total joint arthroplasty – and the BIOLOX® ceramic components shaping the future of patient care. 

CoP ceramic liner and MoP metal femoral head in polyethylene cups; labeled Clinical Results comparing bearing surfaces in primary THA.

Bearing choice and PJI risk: Evidence from a 10,602-patient THA cohort (Rothman Orthopaedics)

Periprosthetic joint infection (PJI) remains a devastating potential complication following total hip arthroplasty (THA). While bearing surface selection has traditionally been discussed in the context of wear and long-term survivorship, a growing body of research suggests that implant material may influence the local immune environment – and even pose the risk of infection.

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BIOLOX®delta CoC monoblock acetabular cup with titanium mesh shell alongside a ceramic-on-polyethylene modular cup; labeled Clinical Results.

BIOLOX®delta ceramic-on-ceramic monoblock vs. ceramic-on-polyethylene modular: what 5 years of radiostereometric analysis reveal for ceramic hip replacement

Drs. Caner Içli and Nina M. C. Mathijssen, together with colleagues at the Reinier Haga Orthopaedic Centre and Reinier de Graaf Gasthuis (Netherlands), have published a new randomized controlled trial in Acta Orthopaedica.

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Pink BIOLOX delta ceramic femoral head and acetabular liner on black background, labelled Clinical Results.

BIOLOX®delta - 4th-generation ceramic-on-ceramic bearings, stability, and low complication rates: a study of 10+ years

A new prospective multicenter study by Lee et al. (University of Gwangmyeong Hospital and others in South Korea) in the Journal of Arthroplasty reports minimum 10-year outcomes of cementless total hip arthroplasty (THA) using 32/36mm BIOLOX®delta CoC bearings (Zimmer Biomet stem/cup system).

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What does the best available evidence tell us about BIOLOX®delta 4th-generation ceramic bearings in total hip arthroplasty?

Profs Carsten Perka, Luigi Zagra, Maziar Mohaddes, Niklas Keller, Axel Ekkenkamp, and Dirk Stengel – hailing from institutions including Berlin’s Charité Medical University Center and Milan’s IRCCS Istituto Ortopedico Galeazzi – are the authors of one of the most comprehensive best-evidence synthesis to date. It draws on eight national registries, 20 systematic reviews, and over two decades of clinical use and real-world data to provide unbiased estimates of advantages and potential risks of 4th-generation ceramic bearings in THA, with a focus on BIOLOX®delta.

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3D render of a BIOLOX® ceramic femoral head and acetabular insert as a ceramic-on-ceramic bearing pair, labeled Clinical Results

Ceramic-on-ceramic tribology is a system & technology question – not a material question alone.

CoC bearings have proven their long-term stability and performance in total hip arthroplasty. But what do we know about the mechanisms behind frictional instability, lubrication transitions, and microstructural damage? A research team at China’s Zhejiang Institute of Medical Device Testing set out to consolidate the current evidence.

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3D render of a BIOLOX®delta ceramic-on-ceramic hip resurfacing implant with clinical results headline.

BIOLOX®delta Ceramic-on-Ceramic Hip Resurfacing: Wear Performance Under Daily Activities

A new wear simulation study jointly published by Prof. Louise Jennings and Raelene Cowie (University of Leeds) and MatOrtho Ltd’s engineering team Danielle de Villiers, Colin Fisher, et al. evaluates the tribological performance of MatOrtho’s ReCerf® ceramic-on-ceramic hip resurfacing (BIOLOX®𝘥𝘦𝘭𝘵𝘢) over a range of daily activities (e.g. walking, jogging). The study moves beyond the standard ISO 14242-1 gait cycle to bearing behavior under more patient-realistic conditions.

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Three THA bearing interfaces side by side: ceramic-on-ceramic, ceramic-on-polyethylene, and metal-on-polyethylene components

How do bearing-surface choices in total hip arthroplasty perform across patient age and follow-up duration?

Bearing selection in THA is not a one-size-fits-all decision. A new network meta-analysis of 59 randomized controlled trials (RCTs) now quantifies what that means, stratified by patient age and follow-up duration.

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Microscopic view of porous ceramic scaffold with study parameters: Y-TZP, ZTA, 60–70% porosity, ovine model, 12–24 weeks.

How might porous ceramic scaffolds aid in bone regeneration? New research dives in.

Bone regeneration after large and complex defects (of which there are about 7 million per year in the US) remains a clinical challenge, particularly when it comes to identifying a scaffold material that combines strong mechanical performance and biological effectiveness.

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Title picture of retrieval analysis on metal fatigue in revision total knee arthroplasty.

About metal fatigue: an underestimated failure mechanism of metal modular knee implants

A retrieval analysis published in the Journal of Orthopaedic Research by Dr. Steve Kurtz et al. (Drexel University) highlights the underestimated risks of metal-related complications in revision total knee arthroplasty (TKA). Although revision TKA remains a laborious and technically demanding procedure, it is generally associated with good clinical outcomes, albeit inferior to those of primary TKA. This study highlights a critical yet under-studied failure mechanism on a microscopic scale: metal fatigue.

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