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Ceramic on Ceramic in Total Hip Replacement
Ceramic-on-ceramic bearings have very low wear rates compared to other bearing surfaces like metal-on-metal and polyethylene. Modern ceramics have improved strength and toughness through advances like high purity materials, hot isostatic pressing, and proof testing. However, ceramic components can still fracture if there is impingement or asymmetric loading. Registry data shows ceramic fracture rates are lower with newer zirconia ceramics like Biolox Delta compared to earlier alumina ceramics, but liner fractures remain a concern. Long term follow up shows ceramic bearings can function well in hip replacements for decades.
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