Ceramic Femoral Heads for All Patients? An Argument for Cost Containment in Hip Surgery.

Trunnionosis and taper corrosion have recently emerged as problems in total hip arthroplasty (THA). No longer restricted to metal-on-metal bearings, these phenomena now affect an increasing number of metal-on-polyethylene THAs and are exacerbated by modularity. Resulting increases in metal toxicity and patient morbidity, and the added costs of toxicity surveillance and revision surgery, will place a substantial economic burden on many health systems. Although they are more expensive than cobalt-chrome heads, ceramic femoral heads make metal toxicity a nonissue. In this article, we provide a theoretical framework for debating whether use of ceramic femoral heads in all THA patients could represent a more cost-effective option.