[Orthopedic Reviews 2014; 6:5334] [page 75]

This report examines the clinical perform-ance of three very similar total hip arthroplas-ty designs with distinctly different bearing sur-faces used over the course 10-17 years. Clinical outcomes assessments for each group are compared in the context of varying implant related costs related to the latest technology at the time of surgery. Eighty-one surgeries were studied and differ by bearing surface. In this study, 36 hips are ceramic on polyethylene, 27 are metal on polyethylene and 18 are metal on metal. All polyethylene components are non-highly cross-linked. The ceramic on polyethyl-ene group has younger patients, on average, and higher percentage of patients with signif-icant polyethylene wear. These groups have an average follow-up time of 8.6 years when assessing functional hip scores, thigh pain, groin pain, revision surgeries and radiograph-ic osteolysis. The implant purchasing cost at the time of surgery was assessed to determine if a correlation exists between outcomes and the more technologically advanced implants use at the time of surgery. Based on midterm clinical outcome assessment, no correlation between initial hospital cost and clinical out-comes of one bearing surface over another can be found