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Updated: Jun 28, 2026

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Ceramic-on-ceramic total hip arthroplasty: update.

William N Capello1, James A D'Antonio, Judy R Feinberg

  • 1Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana 46202-5111, USA.

The Journal of Arthroplasty
|October 24, 2008
PubMed
Summary

Alumina ceramic-on-alumina hip implants show excellent results and fewer erosions compared to metal-on-polyethylene. This study suggests superior performance in young, active patients with total hip replacement.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Medical Device Engineering

Background:

  • Total hip replacement (THR) is a common procedure for osteoarthritis.
  • Conventional polyethylene-on-metal bearings have limitations, including wear and osteolysis.
  • Advancements in bearing materials aim to improve long-term THR outcomes.

Purpose of the Study:

  • To evaluate the clinical outcomes of alumina ceramic-on-alumina ceramic bearing couples in THR.
  • To compare the performance of alumina-on-alumina bearings with conventional polyethylene-on-metal bearings.
  • To assess the incidence of complications and revision rates associated with alumina-on-alumina bearings.

Main Methods:

  • Prospective, randomized, multicenter study.
  • Inclusion of 452 patients (475 hips) with an average age of 53 years.

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  • Follow-up at an average of 8 years, comparing clinical results and radiographic findings.

    • Main Results:

    • Excellent clinical outcomes reported at 8-year follow-up.
    • Significantly fewer cortical erosions observed compared to polyethylene-on-metal bearings.
    • Low revision rate (9 hips) for any reason; 0.5% ceramic liner fracture rate and 0.8% squeaking incidence.

    Conclusions:

    • Alumina ceramic-on-alumina bearings demonstrate superior performance over polyethylene-on-metal bearings in young, active patients.
    • Minimal cortical erosions and no revisions for aseptic loosening indicate long-term durability.
    • Alumina-on-alumina bearings represent a promising option for total hip replacement with enhanced longevity.