| Avoiding Pitfalls in Primary Total Hip Arthroplasty (V)- Index

The Bearing Surface: Ceramic on Ceramic

Michael A. Mont, MD

Historically, controversy has always existed around which bearing surface was the most appropriate for total hip arthroplasty. Early metal-on-metal designs, such as the McKee-Farrar, were plagued by manufacturing problems that led to inappropriate wear with these implants, and consequently the Charnley soft-on-hard bearing surface was utilized by a majority of surgeons. As younger and more patients began receiving total hip replacement, however, implant longevity became a concern with these hard-on-soft bearing surfaces, and hard-on-hard bearings had a resurgence. Recently, however, metal-on-metal bearings have been the subject of mass media recognition, product recalls, and devastating complications related to adverse local tissue reactions.

In light of this, ceramic-on-ceramic is a “hard-on-hard” bearing that may be an alternative to metal bearings in the young, active patient when implant longevity is a concern. The purpose of this presentation will be to educate the attendee regarding: (1) the historical origins and development of modern alumina bearing surfaces; (2) Potential advantages of ceramic bearings; (3) Potential disadvantages of ceramic bearings; (4) Clinical outcomes of these bearings; and (5) give an overview of ceramic-on-metal: the best of both worlds, or an unfeasible combination??

Historical Origins and Development of Modern Alumina Bearing Surfaces


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