title: Ceramic on ceramic arthroplasty of the hip: new materials confirm appropriate use in young patients.
abstract: The leading indication for revision total hip arthroplasty (THA) remains aseptic loosening owing to wear. The younger, more active patients currently undergoing THA present unprecedented demands on the bearings. Ceramic-on-ceramic (CoC) bearings have consistently shown the lowest rates of wear. The recent advances, especially involving alumina/zirconia composite ceramic, have led to substantial improvements and good results in vitro. Alumina/zirconia composite ceramics are extremely hard, scratch resistant and biocompatible. They offer a low co-efficient of friction and superior lubrication and lower rates of wear compared with other bearings. The major disadvantage is the risk of fracture of the ceramic. The new composite ceramic has reduced the risk of fracture of the femoral head to 0.002%. The risk of fracture of the liner is slightly higher (0.02%). Assuming that the components are introduced without impingement, CoC bearings have major advantages over other bearings. Owing to the superior hardness, they produce less third body wear and are less vulnerable to intra-operative damage. The improved tribology means that CoC bearings are an excellent choice for young, active patients requiring THA.
authors.affiliation: Charité University Hospital Berlin, Charitéplatz 1, 10117 Berlin, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Sentuerk
authors.affiliation: Charité University Hospital Berlin, Charitéplatz 1, 10117 Berlin, Germany.
authors.forename: P
authors.initials: P
authors.lastname: von Roth
authors.affiliation: Charité University Hospital Berlin, Charitéplatz 1, 10117 Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Perka
mesh_terms: D000328:Adult; D000367:Age Factors; D000537:Aluminum Oxide; D019644:Arthroplasty, Replacement, Hip; D002516:Ceramics; D006622:Hip Prosthesis; D006801:Humans; D008422:Materials Testing; D008875:Middle Aged; D011474:Prosthesis Design; D015040:Zirconium
chemical_list: D015040:Zirconium; D000537:Aluminum Oxide; C028541:zirconium oxide
keywords: Ceramic on Ceramic; THA; wear