[New materials improve joint prostheses. Metals, polymers, ceramics and composite materials extend the durability]

Advances in our knowledge of multfactorial host-biomaterial interactions have improved the outcome of joint replacement surgery. Fixation and aseptic loosening are the principal foci of research. Wear debris from articulating parts is a major cause of prosthetic loosening. Tribological analysis, and the development of new materials and surface finishes have reduced wear particle production. The use of modular implants increases flexibility and facilitates surgical fit, but also introduces new problems such as dissociation of components, corrosion and wear. In the future, as design, biomaterials and surgical technique become further optimised, arthroplasty may also become an alternative for use in younger patients.