Objectives: An ideal hip implant is biocompatible, withstands dynamic and static loads, and resists chemical and mechanical wear. This paper aims to address failure or revisions, complication rates among different types of bearing surfaces used in total hip arthroplasty.
Methods: This review comprised scientific literature published between 1995 and 2019. We searched PubMed, Scopus, Google Scholar, Embase, and Cochrane Library and included 44 studies on adults (>18 years), all are clinical studies presenting results with more than five years of mean follow-up, and studies including any type of arthritis-all written in English. We enrolled our proposal in the international database of prospectively registered systematic reviews (PROSPERO).
Results: With a total of 8023 hips, 44 studies formed the basis of our findings. For the total population, 77.5% were diagnosed with primary osteoarthritis. The mean age of patients included in this review for MOM, COC, MOP-Conventional, MOP-HXLPE, and COP was 64.2 (10.3), 62.3 (6.8), 62.2 (4.9), 55.14 (6.9), and 59.59 (7.0) respectively. Furthermore, no significant difference was found in the followup period across the bearing surface groups (p=0.209). The revision rate in the COP group was the highest with a percentage of 4.2%, compared to other bearing surfaces. Hips that utilized MOP-HXLPE bearings had the least revision rate of 1.4%.
Conclusion: Many factors can contribute to adverse outcomes in some patient populations. These factors must be considered by the surgeon to optimize patients’ postoperative results. Factors such as implant bearing surface need to be optimized to reduce the rate of revisions.