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Gait analysis at higher walking speeds following ceramic resurfacing, metal resurfacing, and total hip arthroplasty: a comparison

Prof. Justin Cobb of Imperial College London, inventor of Embody Orthopaedic’s H1® hip resurfacing (made with BIOLOX®delta technology), has co-authored a first peer-reviewed study showing a head-to-head comparison of BIOLOX®delta ceramic-on-ceramic hip resurfacing (CoC-HRA), metal-on-metal resurfacing (MoM-HRA), and total hip replacement (THR).

Table comparing clinical gait parameters for ceramic‑on‑ceramic hip resurfacing, metal‑on‑metal hip resurfacing, total hip arthroplasty, and a control group. Displayed metrics include the Oxford Hip Score, MET task score, and top walking speed. A note below the table emphasizes improved high‑speed gait performance with resurfacing and comparable functional results between ceramic and metal resurfacing.

Study stats

  • Prospective, observational cohort
  • 56 male patients with unilateral hip OA + matched healthy controls
  • 17 healthy, asymptomatic, age‐, sex‐, & BMI‐matched participants recruited as controls
  • Delta CoC-HRA (n=19) (Embody Orthopaedic)
  • MoM-HRA (n=19) (Smith & Nephew)
  • Short-stem THR – bearing not specified (n=18) (JRI)
  • Treadmill gait analysis pre-op and ~12 months (40-53 weeks) post-op
  • Walking speed increased stepwise to Top Walking Speed (TWS), with assessment of gait symmetry + ground-reaction force (GRF)

Selected findings suggest…

In this study, both HRA groups showed greater improvement in high-speed walking metrics than the THA group. The authors report that CoC-HRA and MoM-HRA improved TWS, symmetry, and push-off, reaching performance reported as indistinguishable from controls. Short-stem THR improved less than both resurfacing groups.

CoC-HRA & MoM-HRA exhibited symmetrical GRF profiles, with no significant limb differences detected by statistical parametric mapping. By contrast, THR showed an asymmetric GRF pattern, with significantly higher GRF in the nonaffected limb at heel strike (18-28%, p = 0.01).

Replacing the metal bearing with a BIOLOX®delta ceramic bearing in HRA was intended to preserve the favorable clinical and functional outcomes previously associated with hip resurfacing over THA while addressing concerns related to MoM bearings.

As described by Prof. Cobb, this study evaluated a design approach, where ceramic hip resurfacing demonstrated functional outcomes comparable to those observed with MoM-HRA. Importantly, the focus lay on functional gait analysis and was not designed to evaluate material-related biological or immunological performance of these systems.

Study limitations

  • Observational (non-randomized): potential selection bias & confounding
  • Male-only cohort (MoM-HRA contraindicated in females)
  • Symmetry referenced to contralateral hip → monoarticular OA sample
  • Slight variation in pre-op assessment timing

  • Long-term data for CoC-HRA needed

     

Please check for regulatory approval in your country.

This post reflects CeramTec’s summary of a peer‑reviewed scientific publication and does not constitute clinical guidance or product‑related recommendations. The text was created with the support of AI.

 

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