What are the Pros and Cons of a Ceramic Hip Replacement?

R. Bargar

Ceramic hip replacement systems, made of durable ceramic oxides of metal, offer both advantages and disadvantages over hip replacement systems made of metal or polyethylene. Among the advantages of ceramic hip replacements are their durability and that they don't release metal debris into the body, which can occur with metallic artificial hips. The main disadvantages are the cost, the possibility of a fracture and sometimes the noise that they create. Ceramic systems have been in use since the 1970s and have undergone many technological advances over the decades.

Patients may require assistance walking immediately after having hip surgery.
Patients may require assistance walking immediately after having hip surgery.

Long-lasting hip replacement is the main advantage of ceramic hip replacement systems. The ceramics used in hip replacement surgery are alumina ceramic and zirconia ceramic. These are some of the hardest substances known, with only diamond being harder than aluminum oxide ceramics. This hardness provides ceramic hip replacements with an extremely smooth surface, making them much less prone to wear. Frictional wear is minimized with ceramic-on-ceramic artificial hips.

It may be necessary for a patient to re-build her balance skills following a hip replacement procedure.
It may be necessary for a patient to re-build her balance skills following a hip replacement procedure.

Less wear means longer expected functioning when compared with other types of hip replacements. The durability of ceramic hip replacement systems makes them an increasing popular choice for younger and more active artificial hip recipients. Of the two types of ceramic systems, ceramic-on-polyethylene and ceramic-on-ceramic, the latter represents the implant with the least amount of wear to the surfaces.

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Some people may be able to recover more quickly from an operation that utilizes a dynamic hip screw instead of a full replacement.
Some people may be able to recover more quickly from an operation that utilizes a dynamic hip screw instead of a full replacement.

Another benefit of the ceramic hip replacement systems is its suitability for women of childbearing age and for those with metal sensitivities because little debris is generated during wear of the hard, smooth ceramic surfaces. Metallic debris is one of the major disadvantages of metal-on-metal hip replacements, which can disperse metallic debris ranging in size from ions to visible particles. These have the potential to react with cells and tissues in the body. This can cause irritation around the joint and other potential problems. Ceramic hip replacements are a safer choice because no metallic ions are released into the body.

A fractured hip may necessitate a ceramic hip replacement.
A fractured hip may necessitate a ceramic hip replacement.

Disadvantages of ceramic hip replacement systems include the potential for the material to fracture, the expense and noise. Although the ceramics used are extremely hard and durable, like diamond, they are brittle. The ceramic-on-ceramic systems present the greatest risk for fracture. If the system fractures, pieces of broken ceramic can embed in the surrounding tissues. This makes removal of the defective joint difficult.

A ceramic hip replacement can restore mobility.
A ceramic hip replacement can restore mobility.

Another disadvantage is the cost of these hip replacement systems when compared with the older metal-on-metal or metal-on-poly artificial hips. Ceramic systems are the most expensive. Although the cause is still not understood, there also have been documented cases of a squeaking noise produced by ceramic hip replacement systems. This noise is loud enough to be heard when walking or moving. Both the fracturing of the systems and the noise have led to revision surgeries.

An X-ray of the pelvic area, showing a replacement hip.
An X-ray of the pelvic area, showing a replacement hip.
Physical therapy may be necessary following a ceramic hip replacement.
Physical therapy may be necessary following a ceramic hip replacement.

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