Joint replacement - finding your bearings

If you’re considering a joint replacement it is important to understand what will be happening to your joint and what the old bone joint will be replaced with. By understanding the different options available you can make a fully informed decision about which option is best for you.

The bearing is the moving part and in an artificial joint this will inevitably produce debris, which over time can damage the tissues and cause the hip to loosen. Younger patients will tend to be more active and this can increase the amount of debris being produced, which will build up over time.

The choices available

A lot of effort has gone into developing bearings which are more wear resistant, which will hopefully last longer. For younger patients, Mr Bridle suggests the choice is between “ceramic on ceramic” and “ceramic on polyethylene” replacement joints. Both these combinations allow patients to get back to high levels of physical activity if they want to.

Ceramic on ceramic joint replacements are very hard and very smooth, which means that they are a very durable, wear resistant material, with very little friction, allowing a degree of lubrication between the moving parts. Concerns about ceramic on ceramic bearings include the risk of fracture of the material, which can be disastrous (albeit this is a very small risk), along with occasional reports of the joint squeaking, which can be quite disconcerting! Ceramic on ceramic is the most expensive bearing option.

Polyethylene has been used as a bearing in hip replacements for many years. Great efforts have gone into improving this material over the years, as we realised that this was an important source of wear debris, causing hip replacements to fail. Modern polyethylene is far more wear resistant, as we have found ways to make it more durable. In addition polyethylene acts as a ‘shock absorber’ far better than ceramic.

A ceramic on polyethylene bearing combines the advantages of ceramic, which is used for the head component (ball), with those of polyethylene which is used for the socket. Mr Bridle recommends this combination for most of his patients. Testing these bearings in the lab has shown an extremely low wear rate and recent publications confirm that this is reproduced in patients who have had these bearings implanted. We are optimistic that this combination will last just as long as the alternatives, with none of the possible complications.

Making an informed choice

When you’re considering joint replacement you will be able to discuss the pros and cons of the different materials available and make the best choice for you. There is no such thing as a ‘one size fits all’ approach when it comes to joint replacements. Your consultant will be able to offer advice based on your own unique situation, and will be able to answer any questions you have.

Factors such as the age and weight of the patient will need to be discussed and considered, as will the type of lifestyle. These are all important to consider when selecting the most appropriate material for any replacement joint. If you are experiencing joint pain and are considering surgical options, book an appointment today to speak to Mr Bridle so that you can begin exploring different options sooner rather than later.