Ceramic-on-ceramic vs. metal-on-metal in total hip arthroplasty (THA): Do 36-mm diameters exhibit comparable wear performance?

M. Spinelli, S. Affatato, A. Corvi, M. Viceconti

Research output: Contribution to journalArticlepeer-review


Hard-on-hard hip implants were thought as a solution to wear problems affecting polyethylene. Alumina ceramic and metal articulations are harder, biocompatible, and result in reduced wear and particles to the surrounding tissue. Alumina ceramic hip implants produce lower wear rates than other combinations (i.e. metal-on-metal and metal/ceramic-on-polyethylene). However, ceramic presents some limitations: a higher fracture rate in the case of alumina components and hydrothermal degradation for zirconia. On the other end, metal-on-metal articulations have shown in vivo metal ions release and a substantial lymphocytic immune response. The wear of hard-on-hard bearings is affected by various design parameters, such as clearance, surface roughness, and diameter. Last generation large-diameter metal THA designs proved effective wear performance, in in vitro testing, reducing ions release. Moreover such bearing material would prove a cost-effective solution to ceramic designs. Aim of this study was to investigate the wear behaviour of a 36-mm last generation metal-on-metal hip prosthesis and compare it to currently used 36-mm ceramic-onceramic articulations. Wear test was carried out applying an internal protocol based on the current normative. Bovine calf serum was used as lubricant. The weight loss during the whole wear test was lower for the ceramic-on-ceramic combination than for the metal-on-metal one. Significant statistical differences were observed between the two different configurations tested. Our data favoured ceramic-on-ceramic combination rather than metal-on-metal; the total weight loss shows lower values if compared to classic metal-on-polyethylene bearings. It would be very useful to have a significant indicator of wear according to the other influencing design parameters (Cd, Ra, λratio) as to provide more effective design in THA. Nevertheless, a hard-on-hard hybrid coupling could be an interesting solution for the clinical practice, and further studies are needed.

Original languageEnglish
Pages (from-to)94-97
Number of pages4
JournalMaterialwissenschaft und Werkstofftechnik
Issue number1-2
Publication statusPublished - Jan 2009


  • Ceramic
  • Hybrid hip bearings
  • Last generation Metal
  • Wear test

ASJC Scopus subject areas

  • Materials Science(all)
  • Condensed Matter Physics
  • Mechanical Engineering
  • Mechanics of Materials


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