Study of Comparative Outcomes of Different Bearing Surfaces in Total Hip Arthroplasty: A Prospective Study

Abstract

Introduction: Bearing surface choice in total hip arthroplasty (THA) directly influences functional outcomes, complication rates, and implant survival. Aim: To compare outcomes of different bearing surfaces in THA with respect to functional recovery, complications, and revision surgery. Methods: A prospective study was conducted on 80 patients undergoing THA, divided into four groups of 20 each: MOP-HXLPE, COC (Biolox Delta), COP-HXLPE, and Oxinium + HXLPE. Functional outcomes were assessed using Harris Hip Score (HHS), while complications and revision surgeries were recorded. Statistical analysis included descriptive statistics and chi-square tests. Results: All groups showed significant postoperative improvement in HHS. The greatest gains were observed in COC (+50) and Oxinium + HXLPE (+49), compared to MOP-HXLPE (+41). Complications were highest in MOP-HXLPE (15% aseptic loosening, 10% dislocation, 10% osteolysis, 5% infection), while ceramic groups had minimal events. Revision surgery was most frequent in MOP-HXLPE (20%), absent in COC, and low in COP-HXLPE and Oxinium + HXLPE (5% each). Conclusion: Ceramic-on-ceramic and Oxinium + HXLPE bearings demonstrated superior functional outcomes, fewer complications, and lower revision rates compared to metal-on-polyethylene. Bearing surface selection plays a crucial role in ensuring long-term success of THA.

Keywords: Total Hip Arthroplasty (THA), Bearing Surfaces, Ceramic-on-Ceramic (COC), Oxinium + HXLPE