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Increased wettability
4%
50/1169
Increased hardness
11%
125/1169
Increased fracture toughness
62%
720/1169
Decreased surface roughness
5%
53/1169
Lower coefficient of friction
18%
212/1169
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Alternative bearing surfaces in THA have received much attention in recent years as more and more hip arthroplasties are being performed on younger patients with hip arthritis. The two most popular nonmetal-on-polyethylene bearing surfaces are metal-on-metal and ceramic-on-ceramic. There are arguments supporting the use of either, but ceramic bearings have been shown to have a theoretic increased risk of fracture compared with cobalt-chromium. This has been shown to be clinically relevant with zirconium ceramics. Newer alumina ceramics are being produced with lower porosity and grain size and with higher density and purity, resulting in lower fracture risk but still greater than that of cobalt-chromium.
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