Forty years of ceramic-on-ceramic THR bearings

The evolution of ceramic bearings for Total Hip Joint Replacement (THR), which have now been in clinical use for over 40 years, is reviewed from a historical perspective with emphasis on the characteristics of the composite materials in clinical use today, their mechanical properties, and wear behavior. Evidence is provided about the advantage of today’s composite ceramics over those of previous generations in terms of increased reliability and minimum wear, especially in the case of bearings operating under abnormal conditions (edge loading and microseparation).