Alumina Ceramic Bearings in Total Hip Arthroplasty: The Rationale for Patient Selection

The use of alumina ceramic bearings in total hip replacement is not new; extensive clinical outcomes have been reported since at least the past 3 decades. During that time, material advances have changed the basic composition and properties of alumina, such that femoral heads and acetabular inserts made of this material today are vastly superior in reliability, consistency, and durability than counterparts made previously. The question addressed by this article pertains to patient selection for alumina bearings during total hip surgery. To answer this question, the paper is organized to (1) present an overview of the material improvements in modern alumina bearings, (2) review the most recent clinical data related to ceramic bearing performance in total hip replacement, and (3) present practical guidelines based on literature evidence for patient selection for alumina bearings. It is hoped that this information will be of value to the hip arthroplasty surgeon.