Aims. Periprosthetic joint infection (PJI) is a serious complication
of total hip arthroplasty (THA). Different bearing surface materials
have different surface properties and it has been suggested that
the choice of bearing surface may influence the risk of PJI after
THA. The objective of this meta-analysis was to compare the rate
of PJI between metal-on-polyethylene (MoP), ceramic-on-polyethylene
(CoP), and ceramic-on-ceramic (CoC) bearings. Patients and Methods. Electronic databases (Medline, Embase, Cochrane library, Web
of Science, and Cumulative Index of Nursing and Allied Health Literature)
were searched for comparative randomized and observational studies
that reported the incidence of PJI for different bearing surfaces.
Two investigators independently reviewed studies for eligibility, evaluated
risk of bias, and performed data extraction. Meta-analysis was performed
using the Mantel–Haenzel method and random-effects model in accordance
with methods of the Cochrane group. Results. Our search strategy revealed 2272 studies, of which 17 met the
inclusion criteria and were analyzed. These comprised 11 randomized
controlled trials and six observational studies. The overall quality
of included studies was high but the observational studies were
at high risk of bias due to inadequate adjustment for confounding
factors. The overall cumulative incidence of PJI across all studies
was 0.78% (1514/193 378). For each bearing combination, the overall
incidence was as follows:
