Hip replacement has significantly improved the quality of life of patients with symptomatic hip osteoarthritis. Metal-on-metal (MoM) bearings have been used with conventional total hip re-placement (THR) for several decades with promising results from early applications. Wear and corrosion of these implants may lead to a release of metal products into surrounding tissue and body fluids. From the 1980s onwards, the search for increasingly better coupling materials with low levels of wear led to the rise of hard-on-hard couplings such as ceramic-on-ceramic (CoC). The latter is currently the coupling with the longest known duration and with a wear rate close to zero. MoM coupling has been for a long time the most significative alternative, but systemic and local complications linked to the release of chromium and cobalt ions, determine the withdrawn from the market. One other alternative proposed over the time has been Ceramic-on-Metal (CoM) bearing. Preliminary results have been described as favourable, but due to the failures of metal on metal it has been withdrawn from the market, without causing significant clinical complications. In this narrative review, we analysed risks and benefits associated with the implantation of hybrid hard-on-hard bearings, such as CoM.

This observational study aims to depict the impact of gender and socio-economic issues on the health status of Italian Orthopaedic patients during the COVID-19 lockdown. An Ad Hoc ques-tionnaire was developed and online administered. The following data were extracted from the questionnaire: age, body mass index (BMI), education level, distance from hospital, orthopaedic disease, concomitant medical comorbidities, living status (with/without cohabitants) and physical activity level (according to Tegner Activity Scale). The impact of the COVID-19 lockdown was studied analyzing differences related to the above-mentioned parameters. A significant increase of the call number to general practitioner and to the orthopaedic surgeon was observed during the COVID-lockdown, especially in patients with higher education level. Nonetheless, a reduced compliance in drugs assumption was observed in patients with higher education level during lockdown (p=0.007). Almost all the analyzed items were significantly in-fluenced by the distance between patient’s domicile and the nearest hospital. However, no sig-nificant differences were observed comparing pre-COVID to COVID lockdown. In the present study patients’ gender and education level revealed a significant impact on the social behavior during the COVID lockdown, compared with the pre-COVID period.