Reliability of Ceramic Components

As we enter the 4th decade of use, ceramic-on-ceramic total hip arthroplasty remains a viable bearing surface for young and active patients requiring hip replacement. Improvements in manufacturing and component design have continually improved reliability and safety of these implants. Furthermore, the latest iteration of ceramics, which allows for larger head diameters and more head and liner combinations, has further leveled the playing field when it comes to hard-on-hard bearing surfaces. Finally, with recent reports of early failures and unexplained idiosyncratic reactions in patients with metal-on-metal arthroplasty, we suggest that surgeons faced with young and active patients should consider ceramics, with its excellent wear characteristics and biocompatibility, as the only safe hard-on-hard bearing surface suitable for implantation.