Ceramics for hip joint replacement

Abstract

Ceramic materials for total hip replacement (THR) were introduced more than 20 years ago to solve the critical problems of polyethylene wear. Ceramic materials present excellent biocompatibility, mechanical resistance and high wettability. The ideal joint bearing for THR should be able to tolerate high cyclic loading for several decades, without undergoing corrosion or fretting at modular metal tapers, and would possess proven biocompatibility and material stability in vivo, as well as to reduce wear rates. The search for the ideal total joint bearing has led to the development of ceramic bearings. They have shown a good response to the matter of wear, providing the lowest wear rates compared to other material couplings, and could represent an optimum solution for young and active patients who have high risk of loosening or osteolysis in the mid and long term. Bearings made of ceramics (i.e. aluminium oxide and/or zirconium oxide) have been shown to possess extremely low wear properties that make them suitable for THR. Further developments could be made in the direction of reducing the crack propagation, thus diminishing ceramic brittleness.