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Continued trend in ceramic use in Germany

Ceramic Insights of EPRD - ENDOPROTHESENREGISTER DEUTSCHLAND (German Arthroplasty Registry) 2023.

A total of 177,826 hip replacements and 18,145 hip revisions were recorded. 

Bearing use:

  • A ceramic head was used in 90.4% of the primary procedures
  • Continuous growth of CoP bearings, 82.8% in 2022 (67%, 2014)
  • Decrease of CoC bearings, 7.5% in 2022 (15.4%, 2014)
  • Decrease of MoP bearings, 5.3% in 2022 (15.83%, 2014) 


Head size:

  • Increase in use of 36mm femoral heads to 47.1% in 2022 from 31.4% in 2014
  • Corresponding decline in use of 32mm heads from 61.2% in 2014 to 47.8% in 2022
  • 28mm heads remain stable at about 5% over the last 5 years

Reasons for revision: The most common reasons include loosening, infection, periprosthetic fracture, dislocation, and implant wear. There are significantly higher revision rates for bearings with metal heads in elective primary THAs compared to bearings to ceramic heads, with both cemented and uncemented stems.

Note: For the first time the EPRD is providing year-by-year usage trends of different implant parameters, such as fixation, head size, and insert materials. A PROMs data collection pilot has begun in selected hospitals.


Published October 24, 2023

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