What is the best hip replacement material for me? Answers from Dr. Nathan Cafferky

Hip replacement surgery, a transformative procedure for individuals suffering from hip pain and limited mobility, offers a new lease on life. Dr. Nathan Cafferky, a distinguished orthopedic surgeon and joint replacement specialist at The Steadman Clinic, delves into the intricacies of hip replacement materials, shedding light on the diverse options available and their respective benefits for patients.

Understanding Hip Replacement Materials

Hip replacement implants are crafted from a variety of materials, each possessing unique properties and suitability for specific patient needs. Dr. Cafferky emphasizes, "The selection of hip replacement materials is a critical decision, influenced by factors such as the patient’s age, activity level, bone quality, and potential allergies." At this time, Dr. Cafferky offers Metal-on-Polyethylene (MoP) and Ceramic-on-Polyethylene (CoP) replacement options.

What are the different hip replacement materials?

Metal-on-Polyethylene (MoP)

This traditional combination consists of a metal femoral component and a plastic (polyethylene) acetabular (socket) component. Dr. Cafferky notes, "Metal-on-polyethylene implants remain a reliable option for older patients with low to moderate activity levels. They provide durability and stability, with a proven track record of success."

Ceramic-on-Polyethylene (CoP)

Ceramic femoral heads paired with a polyethylene socket offer enhanced wear resistance and reduced friction compared to metal counterparts. "Ceramic-on-polyethylene implants are well-suited for younger, more active patients seeking longevity and reduced wear," Dr. Cafferky remarks. "They are particularly advantageous for those with metal sensitivity.”

Metal-on-Metal (MoM)

MoM implants feature metal components articulating against each other, potentially offering greater durability and range of motion. Dr. Cafferky advises caution with MoM implants stating, "While metal-on-metal bearings may be suitable for select patients, concerns regarding metal ion release and adverse tissue reactions necessitate careful patient selection and monitoring.”

Ceramic-on-Ceramic (CoC)

Utilizing ceramic components for both the femoral head and socket, CoC implants boast exceptional wear characteristics and biocompatibility. "Ceramic-on-ceramic implants are ideal for young, active patients with high demands and longevity expectations," Dr. Cafferky highlights. "They offer excellent durability and reduced wear rates, contributing to long-term implant survival."

Hip Prosthetic Material Classification

Hard on soft (MoP and CoP): MoP, the original low friction arthroplasty, has been surpassed by newer plastics and ceramics with even better wear patterns that can last longer. “This is why I predominantly use CoP for most, if not all, patients now,” said Dr. Cafferky. “With modern hard on soft bearings, we have found that MoP bearings have a 1% risk of failure per year, translating to an 80% chance of lasting 20 years. The newer CoP bearings have the potential to last even longer.”

Hard on hard (MoM and CoC): While hard on hard bearings can last a very long time, they are not without risks and have largely fallen out of favor in the total joint community. Due to concerns such as metal ions, pseudotumors, and adverse soft tissue reactions (ALVAL), “While hard on hard bearings were originally designed for young patients, they come with unacceptable risk profiles, which is why I currently do not offer them,” said Dr. Cafferky. “Additionally, while CoC can be beneficial for very young patients, the potential for an audible squeaking sound during hip movement, although painless, can be extremely bothersome for patients, leading me to not offer CoC implants.”

What hip replacement material is best for me?

The ideal hip replacement material varies depending on individual patient factors and preferences. Dr. Cafferky emphasizes, "Choosing the optimal material involves a thorough evaluation of the patient's age, activity level, bone quality, potential allergies, and long-term goals."

The selection of hip replacement materials plays a pivotal role in the success and longevity of the procedure. Dr. Nathan Cafferky's expertise highlights the nuances of each material option, empowering patients and clinicians alike to make informed decisions tailored to individual needs and expectations. If you are exploring the best hip replacement options, reach out to top hip replacement surgeon Dr. Nathan Cafferky at The Steadman Clinic today.