Ceramics in Total Joint Surgery: The Pros and Cons

The proper role of ceramic bearing surfaces in joint replacement continues to be a topic of concern despite 30 years of clinical application. The advantages and disadvantages of ceramic bearings result from their mechanical and material properties. Ceramics present the unique complication of fracture, which, despite three decades of technology, still is a concern for a variety of reasons. Wear data from properly implanted ceramic-on-ceramic hips is impressive although cross-linked polyethylene is competitive, when all factors are considered. Historical data are now available to support the use of ceramic bearings for hip replacement in a carefully selected patient–surgeon group. An additional group of patients who are hypersensitive to cobalt-chromium alloy constituents may benefit from ceramic-on-ceramic or ceramic-on-polyethylene bearings with titanium metal components.