A prospective study of ceramic-on-metal bearings in total hip arthroplasty at four-year follow-up: clinical results, metal ion levels, inflammatory factor levels, and liver-kidney function

Our study demonstrated that the use of a CoM THA was clinically effective and that metal ion levels were significantly elevated at midterm follow-up. Whether the elevated metal ion levels may reduce adverse reactions is unknown, and long-term follow-up is needed.