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CompletedNCT00208507Updated Nov 7, 2023Results posted

28 mm Ceramic-on-Ceramic Acetabular Cup Total Hip Replacement Study

An interventional study of 28 mm ceramic head on ceramic acetabular liner. and 28 mm ceramic head on polyethylene liner in Joint Diseases, sponsored by DePuy Orthopaedics. Completed at 2 sites in United States. Open to participants aged 20 Years to 75 Years. Per ClinicalTrials.gov, last updated 2023-11-07.

Sponsored by DePuy Orthopaedics · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 2 years 5 months after the study started (first participant enrolled Apr 2003, registered Sep 2005).
Phase
Not applicable
Study type
Interventional
Enrollment
264
Allocation
Randomized
Ages
20 Years to 75 Years
Sex
All
01

Study summary

The study is designed to evaluate artificial hips with a 28 mm ceramic head and a ceramic liner to determine whether they perform as well as artificial hips with a 28 mm ceramic head and a polyethylene liner.

Read the detailed description

Total Hip Arthroplasty (THA) is the surgical reconstruction of the hip joint through replacement of the femoral head and the acetabular articulating surfaces with fixed prosthetic devices. The goals of THA are relief from pain, restoration of function, and correction of deformity. THA is one of the most common adult reconstructive procedures. Over the past 25 years, patients who have needed to have their hip joint replaced, either due to trauma or arthritic disease, typically have had their hip joint bone articular surfaces replaced with a metal hip stem, metal ball head (either stainless steel or chrome cobalt) and a plastic acetabular cup (metal/metal/plastic). While the basic device has remained essentially unchanged over that period, technological advancements in implant designs and materials, and improvements in surgical technique and instrumentation have made THA one of the most durable and successful procedures in medicine. Reproducible, high-quality, short-term and mid-term results are attained regularly, and total hip replacements commonly last 10 to 15 years and longer. The success of this procedure has allowed its expansion into a wider, and often younger and more active population.

In spite of the improvements in THA, little change has occurred for the acetabular cup liner, which is usually made out of Ultra High Molecular Weight Polyethylene plastic (UHMWPe). Because it is plastic and inherently soft and somewhat pliable under load, the cup's articular surface must inevitability wear and produce debris. This biologic response is now thought to be a significant contributor to prosthetic component loosening, a primary failure mode of THR. UHMWPe also degrades with time in the body. As concerns about polyethylene wear and the associated untoward effects of the generated wear debris, and as THA continues to be used in younger and higher-demand patients with increasing life expectancies, interest in ceramic on ceramic total hip prosthesis has been renewed.

An alumina ceramic-on-ceramic acetabular coupling has been employed as an alternative to metal/polyethylene couplings. This ceramic-on-ceramic coupling has many advantages, including the elimination of polyethylene from the device system, wear rates that are appreciably less than those experienced with metal/polyethylene couplings and reduced biologic reactivity. The potential benefits of an alumina ceramic/ceramic bearing are significant.

02

Conditions studied

  • Joint Diseases

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Keywords

  • Joint Diseases
  • Non-Inflammatory Degenerative Joint Disease
03

In context

Joint Diseases

712 studies on the registry are indexed under Joint Diseases; 127 are open to participants now.

This study's enrollment of 264 is above the median of 60 across 470 interventional studies indexed under Joint Diseases.

Browse Joint Diseases studies →

Lead sponsor

DePuy Orthopaedics is the lead sponsor of 42 studies on the registry; 2 are open to participants now.

Of its 8 completed or terminated interventional studies of FDA-regulated products, 8 (100%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
20 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Non-inflammatory degenerative joint disease. Composite diagnoses of NIDJD include osteoarthritis, avascular necrosis, post-traumatic arthritis, slipped capital femoral epiphysis (SCFE), fracture of the pelvis, and developmental dysplasia.
  • X-ray evaluation confirms the presence of NIDJD
  • Femoral and acetabular bone stock is sufficient, regarding strength and shape, and is suitable to receive the implants.
  • Individuals 20 to 75 years of age at the time of surgery
  • Patients with a previous total hip replacement of the contralateral leg who have a pain rating of none or slight and who are at least one year post arthroplasty are eligible for participation in the study.
  • Harris Hip Score of 70 or lower
  • Pain at least Moderate

Exclusion criteria

Exclusion Criteria:

  • Presence of a previous prosthetic hip replacement device (any type, including surface replacement arthroplasty, endoprosthesis, etc.) in the hip joint to be operated.
  • Previous Girdlestone procedure (resection arthroplasty) or surgical fusion of the hip to be operated.
  • Acute femoral neck fracture.
  • Above knee amputation of the contralateral and/or ipsilateral leg.
  • Patients with bilateral degenerative joint disease requiring staged or simultaneous hip replacements.
  • Patients with an existing total hip arthroplasty in the contralateral hip with a Harris Hip pain rating of mild, moderate, marked or totally disabled.
  • Patients who have undergone total hip arthroplasties in their contralateral hips within the past 12 months.
  • Patients with a known allergy to metal (e.g. jewelry).
  • Skeletally immature patients (tibial and femoral epiphyses are not closed). Evidence of active infections that may spread to other areas of the body (e.g., osteomyelitis, pyogenic infection of the hip joint, overt infection, urinary tract infection, etc.).
  • The presence of highly communicable disease or diseases that may limit follow-up (e.g., immuno-compromised conditions, hepatitis, active tuberculosis, etc.).
  • Presence of known metastatic or neoplastic disease.
  • Significant neurologic or musculoskeletal disorders or disease that may adversely affect gait or weight bearing, (e.g., muscular dystrophy, multiple sclerosis).
  • Conditions that may interfere with the total hip arthroplasty's survival or outcome, (e.g., Paget's disease, Charcot's disease).
  • Any patient believed to be unwilling or unable to comply with a rehabilitation program for a cementless total hip replacement or who indicates difficulty or inability to return for follow-up visits prescribed by the study protocol.
  • Patient is known to be pregnant, a prisoner, mentally incompetent, and/or alcohol or drug abuser.
  • Any systemic steroid therapy, excluding inhalers, within three months prior to surgery.
  • Patients carrying the diagnosis of inflammatory degenerative arthritis (IDJD) to include the following composite diagnoses: rheumatoid arthritis, systemic lupus erythematosus, pigmented villonodular synovitis, juvenile rheumatory arthritis and other arthritic processes of inflammatory or autoimmune etiology.
  • Patients requiring structural bone grafts in order to support the prosthetic component(s) or to shape the bone to receive the implant(s).
  • Patients who refuse to provide consent to participate in the clinical investigation.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
264 participants (actual)

Study arms

  • Active comparator
    Delta Ceramax Ceramic-on-Ceramic Acetabular Cup System

    Total hip replacement with a 28 mm ceramic head and liner.

    Device: 28 mm ceramic head on ceramic acetabular liner.

  • Active comparator
    Pinnacle™ Acetabular Cup with Marathon® Polyethylene

    Total hip replacement with 28 mm ceramic head with a polyethylene liner.

    Device: 28 mm ceramic head on polyethylene liner

Interventions

  • Device28 mm ceramic head on ceramic acetabular liner.

    Total hip replacement with 28 mm ceramic head on ceramic liner articulation

    Also known as: Delta Ceramax™ 28 mm Ceramic-on-Ceramic Acetabular Cup

  • Device28 mm ceramic head on polyethylene liner

    Total hip replacement with 28 mm ceramic head on a polyethylene liner articulation.

    Also known as: Detla Ceramax 28 mm ceramic femoral head and Marathon polyethylene liner.

06

What researchers measure

Primary outcomes

  1. Harris Hip Total Score

    The Harris Hip scoring system assigns a numeric value to responses from patients and assessments made by a surgeon. Scores ranges from a minimum of zero to a maximum score of 100. A score of 91-100 is excellent, 81-90 is good, 71-80 is fair, 70 or below is poor. The patient records the following: pain level, need for assistance when walking, presence of a limp, distance able to walk, ability to put on shoes and socks, climb stairs, use public transportation and the length of time one is able to comfortably sit in a chair are all scored.

    Time frame: The Harris Hip Total Score evaluation took place at 6 weeks, 6 months, 12 months, and a final evaluation at 24 months or greater (up to 96 months)

Secondary outcomes

  1. Complication Rates

    Complication Rates are reported by each type of complication (adverse events/AEs) in the Adverse Events Tab

    Time frame: The Complication Rates were evaluated at 6 weeks, 6 months, 12 months, and a final evaluation at 24 months or greater (up to 96 months)

07

Results

Posted Feb 16, 2011

Participant flow

Patients were selected for recruitment into the study from the general diagnosis population defined as "primary total hip arthroplasty (THA) for non-inflammatory degenerative joint disease (NIDJD)." The investigation was conducted at 8 centers. Each center randomly assigned patients to both the investigational and control treatment groups.

Participant flow — Overall Study
MilestoneDelta Ceramax™ Ceramic-on-Ceramic Acetabular Cup SystemPinnacle™ Acetabular Cup With Marathon® Polyethylene
Started17787
Completed16379
Not completed148

Outcome measures

PrimaryHarris Hip Total Score

The Harris Hip scoring system assigns a numeric value to responses from patients and assessments made by a surgeon. Scores ranges from a minimum of zero to a maximum score of 100. A score of 91-100 is excellent, 81-90 is good, 71-80 is fair, 70 or below is poor. The patient records the following: pain level, need for assistance when walking, presence of a limp, distance able to walk, ability to put on shoes and socks, climb stairs, use public transportation and the length of time one is able to comfortably sit in a chair are all scored.

Time frame:
The Harris Hip Total Score evaluation took place at 6 weeks, 6 months, 12 months, and a final evaluation at 24 months or greater (up to 96 months)
Reported as:
Mean · Units on a scale
Harris Hip Total Score
Units on a scaleDelta Ceramax™ Ceramic-on-Ceramic Acetabular Cup SystemPinnacle™ Acetabular Cup With Marathon® Polyethylene
Pre-operative50.5 ± 9.650.8 ± 9.5
6 weeks75.7 ± 12.373.6 ± 12.7
6 months92.2 ± 11.491.4 ± 11.6
12 months94.2 ± 10.193.7 ± 9.6
last follow up of 24 months or greater94.6 ± 9.394.5 ± 8.0
Statistical analysis
  • Delta Ceramax™ Ceramic-on-Ceramic Acetabular Cup System vs Pinnacle™ Acetabular Cup With Marathon® Polyethylene · ANCOVA · p = 0.001 · Mean difference (final values): 0.61Preoperative Harris Hip score was included in the ANCOVA model as the only covariate.
SecondaryComplication Rates

Complication Rates are reported by each type of complication (adverse events/AEs) in the Adverse Events Tab

Time frame:
The Complication Rates were evaluated at 6 weeks, 6 months, 12 months, and a final evaluation at 24 months or greater (up to 96 months)
Reported as:
Number · Complications
Complication Rates
ComplicationsInvestigationalControl
Complication Rates567287

Adverse events

Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Delta Ceramax™ Ceramic-on-Ceramic Acetabular Cup System4/177 (2.3%)27/177 (15.3%)80/177 (45.2%)
Pinnacle™ Acetabular Cup With Marathon® Polyethylene3/87 (3.4%)14/87 (16.1%)44/87 (50.6%)
Most frequent serious events
Showing 10 of 11
Most frequent serious events
EventDelta Ceramax™ Ceramic-on-Ceramic Acetabular Cup SystemPinnacle™ Acetabular Cup With Marathon® Polyethylene
MusculoskeletalMusculoskeletal and connective tissue disorders16/1778/87
Endocrine/MetabolicEndocrine disorders1/1772/87
GastrointestinalGastrointestinal disorders2/1772/87
CancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)3/1772/87
DislocationInjury, poisoning and procedural complications0/1771/87
CardiovascularCardiac disorders1/1770/87
NeurologicalNervous system disorders1/1770/87
GenitourinaryRenal and urinary disorders1/1770/87
RespiratoryRespiratory, thoracic and mediastinal disorders1/1770/87
Acetabular liner failureSurgical and medical procedures1/1770/87
Most frequent other events
Most frequent other events
EventDelta Ceramax™ Ceramic-on-Ceramic Acetabular Cup SystemPinnacle™ Acetabular Cup With Marathon® Polyethylene
MusculoskeletalMusculoskeletal and connective tissue disorders68/17736/87
GenitourinaryRenal and urinary disorders10/1777/87
CardiovascularCardiac disorders11/1776/87
Wound ProblemInjury, poisoning and procedural complications9/1772/87

Baseline characteristics

Age, Continuous
Age, Continuous(years)Delta Ceramax™ Ceramic-on-Ceramic Acetabular Cup SystemPinnacle™ Acetabular Cup With Marathon® PolyethyleneTotal
Mean56.4 ± 10.657.3 ± 10.356.7 ± 10.5
Sex: Female, Male
Sex: Female, Male(Participants)Delta Ceramax™ Ceramic-on-Ceramic Acetabular Cup SystemPinnacle™ Acetabular Cup With Marathon® PolyethyleneTotal
Female8740127
Male9047137
Region of Enrollment
Region of Enrollment(Participants)Delta Ceramax™ Ceramic-on-Ceramic Acetabular Cup SystemPinnacle™ Acetabular Cup With Marathon® PolyethyleneTotal
United States — United States17787264
08

Study locations

2 sites
  • Colorado Joint Replacement
    Denver, Colorado 80210, United States
  • Cardinal Orthopaedic Institute
    Columbus, Ohio 43213, United States
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 7, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00208507
Lead sponsor
DePuy Orthopaedics
Responsible party
Sponsor
First posted
Sep 21, 2005
Start date
Apr 1, 2003
Primary completion
Jan 5, 2012
Completion
Jan 5, 2012
Results posted
Feb 16, 2011
Last update
Nov 7, 2023

Study contacts

Joel Politi, MD
principal investigator · Cardinal Orthopaedic Institute
Douglas Dennis, MD
principal investigator · Colorado Joint Replacement

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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