Logout successfull!
To overview page

AAOS 2026: long-term performance of BIOLOX®delta & BIOLOX®forte ceramic bearings in THA

The AAOS2026 congress was a welcome chance to reconnect with colleagues and to hear how surgeons think about bearing choices. As a ceramic manufacturer with a long clinical history in this field, we focused on the long-term data for ceramic-on-ceramic (CoC) and ceramic-on-HXLPE (CoHXLPE) bearings presented this year.

Three studies in particular – from Kim et al., Park et al., and Seddigh et al. – offered clinically relevant big-picture insights…

Title graphic featuring two ceramic‑on‑ceramic bearing components, BIOLOX®delta and BIOLOX®forte, placed on a dark background with curved line elements. Above the components, the text reads “AAOS 2026 – Long‑Term Performance of BIOLOX®delta & BIOLOX®forte Ceramic Bearings in THA.”
Slide summarizing the Kim et al. study on 20–30‑year outcomes of cementless total hip arthroplasty. The upper section lists study data: 200 patients (400 hips), mean age 46.3, bilateral CoC versus CoHXLPE bearings, and up to 30 years of follow‑up. The lower section presents key findings, including no osteolysis on radiographs or CT, mean liner penetration of 0.041 mm/year, 96.5% stem and 97% cup survivorship, and no ceramic fractures.
Slide showing a summary of Park et al.’s study comparing Delta‑on‑Delta and Delta‑on‑HXLPE total hip arthroplasty in South Korea. The study section lists 15,299 primary THA patients from 2003–2013, with 14,255 receiving Delta‑on‑Delta and 1,044 receiving Delta‑on‑HXLPE. The key findings section highlights higher survivorship for Delta‑on‑Delta, increased early PJI risk and revision risk for Delta‑on‑HXLPE, and no significant group differences in dislocation or periprosthetic fracture.
Slide summarizing the Seddigh et al. post‑approval study of 36 mm Delta ceramic‑on‑ceramic THA. The “Study” section lists 170 patients (172 hips), mean follow‑up 5.6 years, 95.3% Kaplan‑Meier survivorship at 12 years, 4.7% revision rate, and no revisions due to dislocation, infection, or aseptic loosening. The “Key Findings” section reports improved Harris Hip Scores, no ceramic head fractures, one intraoperative liner fracture, noise events in ~21.5% without impact on revision risk or satisfaction, and no association between BMI and revision risk.
Full‑screen text slide containing regulatory information, product availability notes, and scientific disclaimers, followed by three study references: Kim et al. on 20–30‑year outcomes of cementless THA; Park et al. on Delta‑on‑Delta vs Delta‑on‑HXLPE registry data; and Seddigh et al. on post‑approval outcomes of 36‑mm Delta ceramic‑on‑ceramic THA. The slide notes that the content summarizes publicly presented scientific materials and includes references to unpublished data.

Kim et al.: 20- to 30-year bilateral outcomes in younger patients 

  • 200 patients/400 hips, mean age 46.3 years
  • 28mm Duraloc Alumina CoC or Duraloc CoHXLPE
  • Each patient received CoC in one hip and CoHXLPE in the other
  • Mean follow-up 23.1 years (up to 30 years) 

Outcomes

  • No osteolysis detected in either group (radiographs and CT)
  • Mean liner penetration of 0.041 mm/year
  • 96.5% stem survivorship & 97% cup survivorship in both groups
  • No fracture of ceramic heads or acetabular liners reported
  • Squeaking reported in 32 cases, no cases revised

In this younger, active cohort, both CoC and CoHXLPE showed high long-term survivorship and low wear over 2+ decades of follow-up. 

 

Park et al.: national registry data on BIOLOX®delta ceramic

  • 15,299 primary THA patients (2003-2013) received a BIOLOX®delta head at 10-year follow-up
  • 14,255 received DoD, 1,044 DoHXLPE

Key findings

  • 10-year survivorship: DoD 96.5%, DoHXLPE 95.3%
  • Approximately 2× higher risk of PJI in the first year in the DoHXLPE group vs. DoD
  • Revision (any cause): 38% higher risk in DoHXLPE group
  • No significant differences in dislocation or periprosthetic fracture

In this large, real-world cohort, both DoD & DoHXLPE constructs were associated with high 10-year survivorship, with BIOLOX® DoD bearings showing higher survivorship and lower observed risks of infection-related and all-cause revision. 

 

Seddigh et al.: post-approval study of 36mm BIOLOX®delta CoC THA

  • 170 patients/172 hips
  • Mean follow-up 5.6 years
  • Kaplan-Meier survivorship: 95.3% at 12 years
  • Revision rate: 4.7%
  • No revisions due to dislocation, infection, or aseptic loosening

Clinical & bearing-related findings

  • Harris Hip Score improved from 51.3 pre‑op to 92.5 at 5 years
  • No ceramic head fractures during clinical follow-up
  • One intraoperative liner fracture reported
  • Noise events occurred in ~21.5%, mostly transient – no impact on revision risk or patient satisfaction
  • No association between BMI & revision risk

 

These post-approval data reinforce the midterm safety, durability, and functional performance of large-head DoD bearings in real-world clinical use.

Please check for regulatory approval in your country.

 

BIOLOX® LinkedIn