Conclusion
Alumina/alumina bearings will give good service for a long time and that they should be used for patients with a life expectancy of more than 20 years. With further follow-up it may become evident that more ceramic/polythene couples are failing in which case the threshold for routinely using ceramic/ceramic couples may be changed to patients with a life expectancy of 25 years or more. Alumina on polythene will ultimately wear out but, if the patient’s life expectancy is limited, use of this couple would be justified on grounds of easier surgery and cost.
There is a small risk of fracture with alumina/alumina which has to be balanced against a much greater risk of progressive wear in the ceramic/polythene couple. The newer Biolox Delta material should further reduce the incidence of ceramic component failure.
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Buchanan, J.M. (2006). Comparison of polythene liners with alumina liners in hydroxyapatite hip arthroplasty. In: Benazzo, F., Falez, F., Dietrich, M. (eds) Bioceramics and Alternative Bearings in Joint Arthroplasty. Ceramics in Orthopaedics. Steinkopff. https://doi.org/10.1007/978-3-7985-1635-9_31
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