Ceramic-on-polyethylene: The experience of the Ranawat Orthopaedic Center

Traditionally, metal-on-polyethylene has been the gold standard bearing in total hip arthroplasty. Ceramics were introduced as an alternative bearing because of their superior mechanical properties. Our institution has found that ceramic-on-polyethylene has consistently shown lower in vivo wear rates compared to metal-on-polyethylene. The latest generation of ceramic-on-polyethylene, BIOLOX delta-on-highly cross-linked polyethylene, has shown an excellent linear wear rate (0.006 mm/yr), which is much lower than previously found wear rates for cobalt-chrome-on-highly cross-linked polyethylene (0.011 mm/yr). The minimal wear rate of BIOLOX delta-on-highly cross-linked polyethylene provides the potential to increase long-term survivorship and become the new gold standard bearing in THA.