Total Hip Arthroplasty Using Ceramic-on-Ceramic Articulation

Severely collapsed or advanced osteonecrosis (ON) requires total hip arthroplasty (THA). When a THA is performed for ON, problems with polyethylene wear can arise in the medium and long term [1–3]. Furthermore, the wear rate of conventional polyethylene and the prevalence of osteolysis associated with THA in younger patients with ON of femoral head are unacceptably high at the midterm follow-up [1–3]. The factors that contribute to high failure rates include a relatively young age, long life expectancy, higher activity, increased body weight, and poor quality of the femoral bone. Therefore, the minimization of wear is essential for improving the results of THA in these populations. More durable articulations have been introduced, such as highly cross-linked polyethylene-on-metal articulation [4], metal-on-metal articulation [5], and ceramic-on-ceramic articulation [6].