Overall , there was a notable enhancement of joint function after the procedure , with a satisfactory mid- and long-term survival of the ceramic components , which is comparable to that of the conventional alloy components reported previously .
However , revision due to aseptic loosening , wear , and component fracture appeared to be rare , demonstrating the safety of in vivo use of ceramic bearings in the TKA procedure .
Conclusions Ceramic TKA implants show similar post-operative clinical results and survival rate compared to their conventional metallic counterparts .
Our results confirmed the safety of in vivo use of ceramic bearings in TKA , with rare implant breakage and aseptic loosening .
Purpose Ceramic bearings have been widely used in total hip arthroplasty ( THA ) , which result ed in satisfactory clinical outcomes due to the excellent tribological characteristics of the implants .
However , ceramic components are not commonly used in total knee arthroplasty ( TKA ) because of brittleness .
This study aim ed to gather and analyze information regarding the clinical outcomes ( including survival without revision , causes of revision , functional outcome , and incidence of loosening ) and reach a definitive conclusion about the use of ceramic femoral components in total knee arthroplasty .
THA With Delta Ceramic on Ceramic: Results of a Multicenter Investigational Device Exemption Trial
Although the published studies on the outcomes of  total hip arthroplasty (  THA ) performed with currently available ceramic components show high survivorship and low bearing wear at midterm followup , concern over ceramic fracture and squeaking persist . For these reasons , the use of ceramic is limited . Recently , a new alumina matrix composite material ( Delta ceramic ) with improved material properties was developed to address these concerns . We report the early outcomes and complications of a prospect i ve , r and omized , multicenter trial of 263 patients ( 264 hips ) at eight centers , comparing a Delta ceramic-on-ceramic ( COC ) articulation with a Delta ceramic head-crosslinked polyethylene bearing combination ( COP ) . There were 177 COC hips and 87 COP hips . Complications  were reported for all patients , whereas  clinical and radiographic results were provided for the 233 patients with minimum 2-year followup ( average , 31.2 months ; range , 21–49 months ) . The Harris hip scores and clinical , radiographic , and survivorship outcomes were similar in both groups . There were four ( 2 % ) revisions in the COC group and two ( 2 % ) in the COP group . We encountered three intraoperative ceramic liner-related events . In addition , one patient receiving the COC underwent revision for chipping of the ceramic liner , and a second had ceramic fragmentation on followup radiographs but has not undergone revision . These liner related complications remain a concern . No patient reported squeaking in either group ; this leaves us hopeful the new material will lessen the frequency of squeaking . In the short term , the Delta COC articulation provided similar functional scores and survivorship and complication rates with the ceramic head mated with crosslinked polyethylene . Level of Evidence : Level I , therapeutic study . See Guidelines for Authors for a complete description of levels of evidence
Overall , there was a notable enhancement of joint function after the procedure , with a satisfactory mid- and long-term survival of the ceramic components , which is comparable to that of the conventional alloy components reported previously .
However , revision due to aseptic loosening , wear , and component fracture appeared to be rare , demonstrating the safety of in vivo use of ceramic bearings in the TKA procedure .
Conclusions Ceramic TKA implants show similar post-operative clinical results and survival rate compared to their conventional metallic counterparts .
Our results confirmed the safety of in vivo use of ceramic bearings in TKA , with rare implant breakage and aseptic loosening .
Purpose Ceramic bearings have been widely used in total hip arthroplasty ( THA ) , which result ed in satisfactory clinical outcomes due to the excellent tribological characteristics of the implants .
However , ceramic components are not commonly used in total knee arthroplasty ( TKA ) because of brittleness .
This study aim ed to gather and analyze information regarding the clinical outcomes ( including survival without revision , causes of revision , functional outcome , and incidence of loosening ) and reach a definitive conclusion about the use of ceramic femoral components in total knee arthroplasty .