Should I have a total hip arthroplasty done with either a metal-on-metal or ceramic articulating surface?
The weak link in total hip arthroplasty has been the wear-and-tear debris produced by the polyethylene plastic used in the acetabular component. In trying to address the problems of polyethylene wear and the produce of polyethylene wear debris, several new forms of articulation have been introduced. These include a metal-on-metal articulation and a ceramic-on-ceramic articulation. By eliminating the polyethylene at the articulating surface where the parts move against each other, it is hoped that the amount of wear debris will also be significantly reduced. While these are articulations are currently quite new, in fact, they are a reintroduction of techniques and technologies that have been used in the past. Metal-on-metal was used early on in several forms of arthroplasty. While the overall wear rate was reduced, there is still the production of metallic wear debris. Generally, it is felt that there is less biologic reaction to this debris. Metal on metal is also a very strong and dur
