Appendix 1. Full search strategy
((hip prosthesis OR "hip arthroplast* OR tha) AND (ceramic OR alumina OR ceramics) AND
(metal OR cobalt OR chromium OR polyethylene) AND (register* OR cohort* OR random* OR
retrospective* OR prospective*) AND (follow* OR years OR ten)) NOT MEDLINE[sb] PubMed 3
Ovid MEDLINE(R) 1946 to January Week 3 2014
#
Searches
Results
Search Type
1
hip prosthesis/ or arthroplasty, replacement, hip/
28074 Advanced
2
aluminum oxide/ or alumina.mp. or ceramic*.mp. [mp=title, abstract, original title, name
of substance word, subject heading word, keyword heading word, protocol supplementary
concept word, rare disease supplementary concept word, unique identifier]
23259
Advanced
3
(highly adj cross*).mp. [mp=title, abstract, original title, name of substance word, subject
heading word, keyword heading word, protocol supplementary concept word, rare disease
supplementary concept word, unique identifier]
1048 Advanced
4
exp polyethylene/
2897
5
metals/ 31806 Advanced
Advanced
6
5 or metal.mp. or chromium/ or chromium alloys/ or chromium.mp. or cobalt.mp.
[mp=title, abstract, original title, name of substance word, subject heading word, keyword
heading word, protocol supplementary concept word, rare disease supplementary concept
word, unique identifier]
190127
Advanced
7
2 and 3
48
Advanced
8
2 and 4
215
Advanced
9
(3 or 4) and 6 538
Advanced
10
1 and (7 or 8 or 9)
370
Advanced
11
equipment failure/ or prosthesis failure/ or fail*.mp. or durability.mp. or durable.mp. or
stress, mechanical.mp. or weight-bearing/ or debris.mp. or wear*.mp. or fractur*.mp. or
squeak*.mp. or revis*.mp. or dislocat*.mp. [mp=title, abstract, original title, name of substance
word, subject heading word, keyword heading word, protocol supplementary concept word, rare
disease supplementary concept word, unique identifier]
1243284
Advanced
12
reoperation/
63998 Advanced
13
10 and (11 or 12 or surviv*.mp.) [mp=title, abstract, original title, name of substance
word, subject heading word, keyword heading word, protocol supplementary concept word, rare
disease supplementary concept word, unique identifier]
338
Advanced
14
13 and (age factors/ or active*.mp. or young*.mp.) [mp=title, abstract, original title, name
of substance word, subject heading word, keyword heading word, protocol supplementary
concept word, rare disease supplementary concept word, unique identifier]
65
Advanced
15
limit 13 to ("adolescent (13 to 18 years)" or "young adult (19 to 24 years)" or "adult (19 to
44 years)" or "young adult and adult (19-24 and 19-44)" or "middle age (45 to 64 years)" or
"middle aged (45 plus years)")
211
Advanced
16
14 or 15
224
Advanced
17
16 and follow-up studies/
18
Registries/
81
Advanced
50792 Advanced
19
16 and (cohort*.mp. or 18 or randomized controlled trial.pt. or comparative study/ or
prospective*.mp. or retrospective*.mp.) [mp=title, abstract, original title, name of substance
word, subject heading word, keyword heading word, protocol supplementary concept word, rare
disease supplementary concept word, unique identifier]
138
Advanced
20
16 and (longitudinal studies/ or longterm.mp. or "long-term".mp.) [mp=title, abstract,
original title, name of substance word, subject heading word, keyword heading word, protocol
supplementary concept word, rare disease supplementary concept word, unique identifier]
44
Advanced
21
19 and 20
33
Advanced
22
19 and (years or ten or year).mp. [mp=title, abstract, original title, name of substance
word, subject heading word, keyword heading word, protocol supplementary concept word, rare
disease supplementary concept word, unique identifier]
120
Advanced
23
21 or 22
124
Same strategy CENTRAL = 35
Embase 1988 to 2014 Week 03
#
Searches
Results
1
exp total hip prosthesis/
Search Type
19193 Advanced
2
ceramics.mp. or ceramic prosthesis/ [mp=title, abstract, subject headings, heading word,
drug trade name, original title, device manufacturer, drug manufacturer, device trade name,
keyword]
13285 Advanced
3
alumina.mp. or aluminum oxide/ [mp=title, abstract, subject headings, heading word,
drug trade name, original title, device manufacturer, drug manufacturer, device trade name,
keyword]
12156 Advanced
4
(highly adj cross*).mp. [mp=title, abstract, subject headings, heading word, drug trade
name, original title, device manufacturer, drug manufacturer, device trade name, keyword]
1236 Advanced
5
(polyethylene or polyethylene derivative).mp. [mp=title, abstract, subject headings,
heading word, drug trade name, original title, device manufacturer, drug manufacturer, device
trade name, keyword] 38386 Advanced
6
metal/ or chromium/ or cobalt/
7
(2 or 3) and (4 or 5)
8
6 and (4 or 5 or 2 or 3)
9
limit 8 to adult 510
1184
69010 Advanced
Advanced
2629
Advanced
Advanced
10
8 and (young* or active*).mp. [mp=title, abstract, subject headings, heading word, drug
trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword]
261
Advanced
11
9 or 10 690
Advanced
12
11 and follow up/
216
Advanced
13
clinical study/ or exp case control study/ or exp case study/ or exp clinical trial/ or exp
"clinical trial (topic)"/ or exp longitudinal study/ or exp major clinical study/ or exp retrospective
study/ or comparative study/ 3222399
Advanced
14
11 and 13
283
Advanced
15
12 and 14
143
Advanced
16
register/
58492 Advanced
17
11 and 16
6
18
15 or 17
148
Advanced
Did you mean: (((TOPIC: ((Hip SAME ((prosthesis OR prostheses) OR arthroplast*)) AND
((young* OR "middle-age*") OR active*)) AND TOPIC: (((((coc OR ceramic*) OR alumin*) OR
metal) OR chromium) OR cobalt)) AND TOPIC: (("highly cross*" OR polyethylene) OR clpe))
AND TOPIC: ((((((((random* OR cohort*) OR register) OR registr*) OR follow?up) OR
longitudinal) OR year) OR ten) OR longterm)) [178 results]
Appendix 2. Study selection details
When a published, updated study involving the same cohort of patients was identified, only the
latest update was included in the analysis. At the level of full article review, 14 manuscripts were
excluded because a more recent report from a randomized controlled trial (RCT) was available
[7-9, 15-18, 20, 25, 42, 45, 48, 56, 60]. Another 51 studies were excluded because they did not
employ an RCT study design [1-6, 10-14, 19, 21-24, 26-28, 30-37, 40, 41-44, 46, 47, 49, 50, 5255, 57, 59, 61-67, 69, 70]. Three studies were excluded because they did not examine one of
the bearings of interest to this review [29, 38, 68]. One study was excluded because it only
examined short-term radiographic outcomes [51] and a final study was excluded because the
average patient age was older than 65 years old [58]. Many of the excluded studies met more
than one exclusion criteria.
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3.
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4.
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20.
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21.
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22.
Fehring TK, Fehring K, Springer BD, Masonis JL, Dennos AC. Comparative analysis of periarticular
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23.
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24.
Garcia-Cimbrelo E, Garcia-Rey E, Murcia-Mazon A, Blanco-Pozo A, Marti E. Alumina-on-alumina
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25.
Garcia-Rey E, Garcia-Cimbrelo E, Cruz-Pardos A, Ortega-Chamarro J. New polyethylenes in total
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26.
Geller JA, Malchau H, Bragdon C, Greene M, Harris WH, Freiberg AA. Large diameter femoral
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27.
Ha YC, Koo KH, Jeong ST, Yoo JJ, Kim YM, Kim HJ. Cementless alumina-on-alumina total hip
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28.
Hamadouche M, Nizard RS, Meunier A, Sedel L. [Cementless acetabular fixation of bulk alumina
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29.
Hernigou P, Homma Y, Pidet O, Guissou I, Hernigou J. Ceramic-on-ceramic bearing decreases the
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30.
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31.
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32.
Inacio MC, Ake CF, Paxton EW, Khatod M, Wang C, Gross TP, Kaczmarek RG, Marinac-Dabic D,
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33.
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34.
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46.
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47.
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48.
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49.
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50.
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51.
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52.
Park YS, Hwang SK, Choy WS, Kim YS, Moon YW, Lim SJ. Ceramic failure after total hip
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53.
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54.
Petsatodis GE, Papadopoulos PP, Papavasiliou KA, Hatzokos IG, Agathangelidis FG, Christodoulou
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55.
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alumina liners. Int Orthop. 2003;27:85-89.
56.
Seyler TM, Bonutti PM, Shen J, Naughton M, Kester M. Use of an alumina-on-alumina bearing
system in total hip arthroplasty for osteonecrosis of the hip. J Bone Joint Surg Am. 2006;88(Suppl 3):116125.
57.
Shia DS, Clohisy JC, Schinsky MF, Martell JM, Maloney WJ. THA with highly cross-linked
polyethylene in patients 50 years or younger. Clin Orthop Relat Res. 2009;467:2059-2065.
58.
Thomas GER, Simpson DJ, Mehmood S, Taylor A, McLardy-Smith P, Gill HS, Murray DW, GlynJones S. The seven-year wear of highly cross-linked polyethylene in total hip arthroplasty: a doubleblind, randomized controlled trial using radiostereometric analysis. J Bone Joint Surg Am. 2011;93:716722.
59.
Topolovec M, Milosev I. A comparative study of four bearing couples of the same acetabular and
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60.
Vendittoli P, Girard J, Lavigne M, Lavoie P, Duval N. Comparison of alumina-alumina to metalpolyethylene bearing surfaces in THA: a randomized study with 4- to 9-years follow-up. Acta Orthop
Belg. 2007;73:468-477.
61.
Wang S, Zhang S, Zhao Y. A comparison of polyethylene wear between cobalt-chrome ball heads
and alumina ball heads after total hip arthroplasty: a 10-year follow-up. J Orthop Surg Res. 2013;8:20.
62.
Weiss RJ, Hailer NP, Stark A, Karrholm J. Survival of uncemented acetabular monoblock cups:
evaluation of 210 hips in the Swedish Hip Arthroplasty Register. Acta Orthop. 2012;83:214-219.
63.
Yang LQ, Li X, Fu Q. Comparison of the early effect of ceramic-on-ceramic with metal-onpolyethylene total hip prosthesis replacement. Chinese Journal of Tissue Engineering Research.
2012;16:9691-9696.
64.
Yang LQ, Li X, Fu Q, Wang C. [Comparison of early clinical effects of two hip prosthesis designs
between ceramics to ceramics and metal to polyethylene] [in Chinese]. Zhongguo Gu Shang.
2013;26:561-564.
65.
Yoo JJ, Kim YM, Yoon KS, Koo KH, Kim JW, Nam KW, Kim HJ. Contemporary alumina-on-alumina
total hip arthroplasty performed in patients younger than forty years: a 5-year minimum follow-up
study. J Biomed Mater Res B Appl Biomater. 2006;78:70-75.
66.
Yoo JJ, Kim YM, Yoon KS, Koo KH, Song WS, Kim HJ. Alumina-on-alumina total hip arthroplasty--a
five-year minimum follow-up study. J Bone Joint Surg Am. 2005;87:530-535.
67.
Yoon TR, Rowe SM, Kim MS, Cho SG, Seon JK. Fifteen- to 20-year results of uncemented tapered
fully porous-coated cobalt-chrome stems. Int Orthop. 2008;32:317-323.
68.
Zijlstra WP, Bos N, van Raaij JJ. Large head metal-on-metal cementless total hip arthroplasty
versus 28 mm metal-on-polyethylene cementless total hip arthroplasty: design of a randomized
controlled trial. BMC Musculoskelet Disord. 2008;9:136.
69.
Zweymuller KA, Steindl M, Schwarzinger U. Good stability and minimal osteolysis with a
biconical threaded cup at 10 years. Clin Orthop Relat Res. 2007;463:128-137.
70.
Zywiel MG, Sayeed SA, Johnson AJ, Schmalzried TP, Mont MA. Survival of hard-on-hard bearings
in total hip arthroplasty: a systematic review. Clin Orthop Relat Res. 2011;469:1536-1546.