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Objectives Total hip arthroplasty (THA) with Ceramic‐on‐Ceramic (CoC) components achieved excellent outcomes. However, the long‐term outcomes of anatomic and tapered stems are controversial in clinical practice, and the difference in the survival rates between the tapered stems and anatomical stems over the long term remains unknown. Methods A retrospective cohort study was performed to evaluate the 11‐year follow‐up outcomes of anatomic and tapered femoral stems. Between January 2009 and December 2011, a total of 1438 patients with COC were included in this study initially. Among these hips, 30 patients (30 hips) experienced death, and 254 hips (17.6%) were lost to follow‐up. Finally, a total of 591 hips with Corail stem and a total of 334 hips with Ribbed stems were included in this study. The outcomes were evaluated by the modified Harris hip score (mHHS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and a questionnaire assessing articular noises. Results For the Corail stem, the survival rate with aseptic loosening or revision of any component for any reason as the endpoint was 99.1% at 11 years. The survival rate with reoperation for any reason as the endpoint was 98.8% at 11 years. For the Ribbed stem, the survival rate with aseptic loosening or revision of any component for any reason as the endpoint was 98.8% at 11 years. In patients with the Corail stem, the preoperative modified Harris hip score (mHHS) score, with a mean of 43.8 points, significantly improved to a mean of 93.5 points at the final follow‐up assessment (p < 0.001). In patients with the ribbed stem, the preoperative mHHS score, with a mean of 40.9 points, significantly improved to a mean of 92.8 points at the final follow‐up assessment (p < 0.001) during the follow‐up period. The incidence of squeaking and squaking in the Corail group was significantly higher than that in the ribbed group (squeaking: 22.7% vs. 6.9%; squaking: 17.4% vs. 4.2%). The incidence of postoperative thigh pain was 4% in patients with the Corail stem, significantly lower than that in patients with the ribbed stem (17.4% vs. 4%; p < 0.001). Conclusion In conclusion, CoC THA with Corail and Ribbed stems exhibits excellent clinical outcomes at the long‐term follow‐up. However, the incidence of postoperative thigh pain in the Ribbed group is significantly higher than that in the Corail group, while the incidence of squeaking was lower. CoC THA with Corail and Ribbed stems exhibits excellent survival and clinical outcomes at the long‐term follow‐up. However, the incidence of postoperative thigh pain in the Ribbed group is significantly higher than that in the Corail group, while the incidence of squeaking was lower.

Background Whilst bony fixation of hip replacement has stable solutions, there remains controversy over which bearing best optimizes longevity and function. Ceramic-on-ceramic (CoC) bearing combinations are associated with lower risk of revision due to aseptic loosening and dislocation. Evidence for long-term functional outcomes of modern, 4th generation CoC bearings is limited. The aim of this study was to analyze outcomes and complications of the R3™ Acetabular System (Smith & Nephew, Inc., Cordova, TN, USA) in combination with BIOLOX® Delta ceramic femoral head in patients undergoing primary total hip arthroplasty (THA). Methods Between June 2009 and May 2011, 175 patients (178 hips) were enrolled into a prospective, study at 6 sites in Europe and prospectively followed-up at 3 months and 1, 3, 5, and 7 years postoperative. Results Total WOMAC score improved from 63 (range, 22–91) preoperative to 8 (range, 0–8) at 1-year follow-up and remained unchanged at 7-year follow-up. Modified Harris hip score improved from 45 (range, 10–87) preoperative to 83 (range, 25–100) at 3 months, 91 (range, 42–100) at 1 year, and 92 (range, 46, 100) at 7 years. UCLA Activity Rating Scale score improved from 3.3 (range, 1–8) preoperative to 6.2 (range, 2–8) at 1 year; it marginally declined to 5.8 (range, 3–8) at 7-year follow-up. There were 4 trochanteric fractures and 5 patients died of unrelated reasons. Three hips were revised (2 periprosthetic fractures and 1 subluxation). The 7-year cumulative survival rate was 98.3%. Conclusion Clinical and functional improvements of THA with CoC bearing are maintained at 7 years postoperative. Trial registration ClinicalTrials.Gov, NCT03566082 , Registered 10 January 2018—retrospectively registered,