The Promise and Perils of Ceramics in Artificial Hips
By Barnaby J. Feder
May 11, 2008 - In the past, doctors routinely advised young and active patients to live as long as possible with hip pain before getting their first implant, in hopes of avoiding a second replacement.
Then research in the 1990s suggested that a ceramic compound developed by CeramTec, a German subsidiary of a Princeton, N.J., company called Rockwood Holdings, was up to 200 times more wear resistant than the traditional plastic hip sockets.
It also appeared to be less brittle than earlier ceramic compounds, which had disturbingly high fracture rates when orthopedics companies had tried them on patients.
Stryker’s Trident, containing the CeramTec material, looked like the clear durability winner when it went on sale in 2003. Hip prices vary widely, but Stryker reportedly received anywhere from $3,200 to more than $10,000 for Tridents — often at a 50 percent premium over hips made of other materials.
Wright Medical, a small competitor, received approval for a ceramic design soon after Stryker. Major hip makers like Biomet, Zimmer Holdings and Johnson & Johnson’s Depuy Orthopaedics subsidiary raced to catch up, all of them using the CeramTec compound.
Within two years, the Trident accounted for more than a third of Stryker’s hip sales. But now, as a result of concerns about squeaking, Trident is down to 10 percent of Stryker’s hip sales and all the ceramic models on the market together make up perhaps only 5 percent of the United States total.
And the national average selling price for the ceramics last year was $7,400 — only a $500 premium over metal-on-metal hips, according to Millennium Research Group.
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