A study presented by Cliff Colwell, M.D. at the knee society, during the 75th annual American Academy of Orthopaedic A recent article appeared in the Seattle Times, written by Barnaby J. Feder a New York Times columnist, describing the experience of some patients who had ceramic-on-ceramic total hips. As I mentioned in previous blogs, there has been some concern by both healthcare professionals and patients about squeaking after ceramic-on-ceramic hip. The incidence seems to be higher in hips manufactured by certain companies.  The article does a good job outlining the problems and possible causes. I do take exception with some of the statements in the article, for example, where Mr. Feder states these patients were “guinea pigs in a unfolding medical mystery”. Use of ceramic-on-ceramic articulation in total hips has a fairly long track record over the last 30-years. There have been improvements and modifications to the ceramic material but changes in a material can lead to some unexpected outcomes. In general ceramic-on-ceramic articulations are very durable and safe. There are some evolving questions that will need to be addressed and more likely than not involve design modifications to this particular hip. The article also states that total hip replacement can cost as much as $45,000.00. In fact, Medicare reimburses most hospitals in the Northwest part of the country, roughly $9800.00 for a total hip replacement and the physicians’ reimbursement is approximately $1700.00. So while costs may be high, the actual reimbursement is significantly lower for these procedures. It is important to discuss with your surgeon what type of hip they plan on implanting and the specific bearing surface they are most comfortable using. There are no clear-cut winners in this race and time will tell which articulation proves to be the more durable and functional.

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  1. Rich Hill

    Medicare $9800 allowance vs $45,000 cost. I as patient needing a Hip replacement find difficult at 74 yrs to get 1) a first rate implant and surgeon that wil work for Medicare rates and 2) seems hard to find sources that will let me pay at good insurance on self pay basis.

    Something is wrong with this system!