Ceramic humeral heads in shoulder arthroplasty: a systematic review

source extracted confidence: high 2026-04-09
#humans #ceramics #arthroplasty-replacement-shoulder #prosthesis-design #shoulder-prosthesis

Ceramic humeral heads in shoulder arthroplasty: a systematic review

Harris et al., 2025 | J Shoulder Elbow Surg | Systematic Review

Citation

Harris Chandler S, Ibrahim Saad M, ... Brabston Eugene W. Ceramic humeral heads in shoulder arthroplasty: a systematic review. J Shoulder Elbow Surg. 2025-Sep;34(9):2278-2286. doi:10.1016/j.jse.2024.12.024

Abstract

HYPOTHESIS: Total shoulder arthroplasty has been used for over 50 years to treat glenohumeral arthritis. In recent years, one area of innovation has been the use of ceramic-bearing surfaces. The advantages of ceramic bearing surfaces include utility in stemless implants and hemiarthroplasty, where their use in hip arthroplasty has been shown to decrease wear rates compared to metal implants and potentially reduced revision rates. With interest in utilizing ceramics for other arthroplasty indications continuing to grow, the purpose of this systematic review is to consolidate recent clinical findings involving ceramic-bearing surfaces to determine their suitability for anatomic shoulder replacement. METHODS: Medline, Embase, and Cochrane Library were searched up to April 2024 according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Metrics analyzed include patient-reported outcome measures, postoperative complications, and radiographic findings. Secondary outcomes included forward flexion, external rotation, and abduction. RESULTS: Eight studies comparing 716 patients were included with an average follow-up of 57.3 months (range 24-70.7). The mean age for the study population was 67.7 year old. All 8 studies included cohorts that had undergone shoulder arthroplasty with an implant with a ceramic humeral head component. All studies showed significant improvement in range of motion and patient outcome scores both postoperatively and up to 2 years after the patient's initial operation. Patient satisfaction was similarly positive, with 97% of patients reporting satisfactory results. Radiographically, 6 studies reported Lazarus grades with 71.9% (213/296) were grade 0, 23.3% (69/296) were grade 1, 3.7% (11/296) were grade 2, and 0.67% (2/296) demonstrated a grade 3 Lazarus score. One study presented a patient with a grade 5 Lazarus, making up only 0.34% (1/296) of the observed population. CONCLUSION: Anatomic shoulder replacements using ceramic-bearing surfaces show safety and efficacy at numerous follow-up intervals, with complication rates approaching those of historical controls with metal implants. Future randomized controlled trials should be performed to investigate potential advantages compared to titanium and cobalt-chromium alloy humeral heads.

Key Findings

Eight studies comparing 716 patients were included with an average follow-up of 57.3 months (range 24-70.7). The mean age for the study population was 67.7 year old. All 8 studies included cohorts that had undergone shoulder arthroplasty with an implant with a ceramic humeral head component. All studies showed significant improvement in range of motion and patient outcome scores both postoperatively and up to 2 years after the patient's initial operation. Patient satisfaction was similarly posit

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 716
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Ceramics
  • Arthroplasty, Replacement, Shoulder
  • Prosthesis Design
  • Shoulder Prosthesis
  • Range of Motion, Articular
  • Humeral Head
  • Shoulder Joint

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: chromium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09