A titanium-encased alumina ceramic bearing for total hip arthroplasty: 3- To 5-year results

James A. D'Antonio, William N. Capello, Michael T. Manley, Marybeth Naughton, Kate Sutton

Research output: Contribution to journalArticle

46 Scopus citations


We examined whether encasing the alumina ceramic total hip arthroplasty insert in a thin titanium sleeve would reduce significantly or eliminate insert chipping on impaction of the insert into the shell. We also compared results, including observations of osteolysis, of the Trident® study group with those of the predecessor alumina bearing couple design to determine clinical improvement and radiographic stability. Beginning in October 1996, 328 alumina ceramic bearings were implanted by six surgeons in 316 patients as a part of a prospective, randomized United States Investigational Device Exemption three-arm study comparing an alumina ceramic bearing with a control bearing of cobalt-chromium on polyethylene. In September 1999, a fourth arm of the study (Trident®) was added. The Trident® insert was recessed within a thin titanium sleeve. At three to five years followup, osteolysis was found in 0% of the patients with the Trident® insert and in 0.5% of the patients with an alumina bearing couple. At a mean followup of 4.2 years (range, 3-5 years) no ceramic chips, fractures, or ceramic bearing failures have occurred. Encasing the alumina ceramic insert in a titanium sleeve seems to have resolved the issue of insert chipping on impaction and supports the continued use of Trident® bearings in relatively young patients.

Original languageEnglish (US)
Pages (from-to)151-158
Number of pages8
JournalClinical Orthopaedics and Related Research
Issue number441
StatePublished - Dec 2005

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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