Ceramic-on-ceramic bearings: Assured longevity in patients younger than 60 years?

Ceramic-on-ceramic bearings are used in around a fifth of all total hip arthoplasties carried out in Australia. The Australian Orthopaedic Assocation National Joint Replacement Registry data from 2016 shows that ceramic has better 15-year survivorship than any other bearing surface, even in patients under the age 55 years. Wear rates can be measured on retrieval analysis and patterns of wear identified. Ceramic also demonstrates good biocompatibility with very little inflammatory response to debris produced in comparison with polyethylene and metal-on-metal bearing surfaces. Squeaking is an infrequent complication and rarely a cause of revision.