Mixing and matching in ceramic-on-metal hip arthroplasty: An in-vitro hip simulator study

Saverio Affatato, Michele Spinelli, Stefano Squarzoni, Francesco Traina, Aldo Toni

Research output: Contribution to journalArticlepeer-review


The clinical success of second-generation metal-on-metal hip replacement and the good tribological performance of alumina ceramic revived an interest in hip articulation as a solution to reduce wear. This study was aimed at characterizing the wear behaviour of new hybrid ceramic-on-metal bearings. In particular, this study investigated the wear behaviour of ceramic-on-metal hip components (three different diameters configurations: 28, 32 and 36 mm), not specifically proposed to be coupled, in order to compare them with ceramic-on-ceramic, which is considered to be the gold standard for wear resistance. For this purpose, the weight loss over a standard wear simulation was monitored. Moreover, scanning electronic microscope observations were used to verify if any carbides removal, for the metallic components, triggered wears debris production promoting abrasive third-body wear. After five million cycles, our results showed significantly greater wear-in ceramic-on-metal compared with ceramic-on-ceramic, and significant greater wear for the 32-mm diameter compared with the 36-mm one. Our findings showed an increase in wear for the proposed hybrid specimens with respect to that of the ceramic-on-ceramic ones confirming that even in the case of ceramic-on-metal bearings, mixing and matching could not prove effective wear behaviour, not even comparable with that of the ceramic-on-ceramic gold standard. Wear patterns and roundness tolerances certainly discourage the coupling of components not specifically intended to be coupled. Unsuitable geometrical conformity could, in fact, result in a poor dynamic behaviour and lead to clinical failure.

Original languageEnglish
Pages (from-to)2439-2446
Number of pages8
JournalJournal of Biomechanics
Issue number15
Publication statusPublished - Nov 13 2009


  • Ceramic-on-metal
  • COC
  • COM
  • Hip wear rate
  • Roundness measurements
  • SEM

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Rehabilitation
  • Biophysics
  • Biomedical Engineering


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