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Options for bearing surfaces in total hip replacement

There are several options for bearing surface combinations in total hip replacement. Fortunately, all of these options have very good track records and each bearing brings its own pluses and minuses. By far, the most commonly used bearing in the United States today is a cobalt chrome head against a highly cross-linked polyethylene (plastic) insert. This is used in approximately 80% of cases performed.

The next most commonly used bearing is a metal-on-metal alternative. This has very low wear properties but recent reports indicate a 1-2% incidence of allergic type reaction to metal ions from the articulating surface. We have reviewed a large series and have presented it at the Western Orthopedic Association, documenting our incidence of adverse type reaction as less than 1%. Further study of this bearing surface is currently taking place.

The next most common alternative is ceramic on ceramic. This has an extremely low wear rate but has a documented squeak phenomenon, ranging from 2-7%. The etiology of squeaking is not entirely clear but seems to be multi-factorial, including implant design, surgical technique, and material. Further study will help delineate the most important factors involved in squeaking.

You should discuss your options with your surgeon and decide which bearing combination is right for you.

For more information, please visit our joint replacement page.

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4011 Talbot Rd S #300
Renton, WA 98055

Phone: 425.656.5060
Fax: 425.656.5047

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27005 168th Pl SE #201
Covington, WA 98042

Phone: 253.630.3660
Fax: 253.631.1591

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Maple Valley, WA 98038

Phone: 425.358.7708
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Tukwila, WA 98188

Phone: 425.979.BONE

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