[Further development of the graded-shaft fixation principle]

A new concept is presented for the design of total hip prostheses. After the discussion of the commonly used gliding materials the use of ceramic-ceramic gliding surfaces is justified in respect to its minimal wear rate. The most important biomechanical recommendations concerning the design of femoral stems and ceramic acetabular cups are summarized. Own clinical results with a ceramic-ceramic cementless hip endoprostheses are presented. A new concept of femoral stem fixation is introduced in consequence of those biomechanical recommendations and of own clinical experiences. 4 photographs are showing the new stem design.