Clinical experience with Ceramic on Ceramic in the USA

Abstract

Ceramic on Ceramic total hip arthroplasty (THR)has had a very long history as a low wear bearing material. With initial problems related to primarily fixation. That problem seemed to be solved with the advent of reliable cementless components, and the uncoupling of bearing and fixation functions. In the United States, 11 years have now passed since the first Food and Drug Administration (FDA) approved studies began, and four years have elapsed since the FDA approved the first Ceramic-Ceramic hip replacements for general use. Although the results of these multiple studies have continued to demonstrate the superior wear bearings of ceramics, the advent of highly cross-linked polyethylene, the relative lack of liner and ball head options, the occasional fracture, and now the report of an occasional squeaking hip have impeded more robust acceptance of these advanced bearing devices.