Bearing Surface Choice: A European Experience

The choice of bearing surfaces in Europe is subject to several factors such as marketing system and support, expenditure on health and reimbursement, age and activity level, different medical education and tradition. Our study shows an inhomogenous situation concerning the distribution of bearing surfaces in Europe. Our evaluation revealed that in Scandinavian countries, modular crosslinked PE inserts in combination with modular metal ball heads are dominant. In Central Europe, modular crosslinked and ceramic inserts combined with modular ceramic ball heads are favored. Countries like UK, Ireland, Spain, Portugal, Czech. Rep. and Poland mainly use modular standard and crosslinked PE inserts paired with modular metal ball heads. In our view we see a rising trend for advanced bearings, which means that more ceramic or crosslinked inserts paired with ceramic ball heads would be used in total hip replacement in Europe.