| The most common bearing surface historically used in | | | | Metal on Metal bearing is a good choice for young |
| Total Hip Replacement is a Stainless steel femoral | | | | individuals. |
| head with a High density polyethylene Acetabular cup. | | | | Not advisable in Women in Child bearing age group; |
| This is still a good, cost-effective option in elderly, | | | | kidney disease; metal hypersensitivity patients. |
| low demand patients. | | | | Ceramic on Ceramic is low wear bearing surface; |
| However, with the availability of technology, and | | | | however there is risk of component fracture due to |
| newer implant generation, there is trend towards | | | | mal-position. Another drawback of ceramic on |
| alternative bearing surfaces. | | | | ceramic articulation is Squeaking (abnormal audible |
| The three most common bearing materials in use are: | | | | sound). Besides, it can not incorporate large size |
| 1) Metal On UHMWPE (High density polyethylene) | | | | articulations, because it requires a metal shell for |
| 2) Metal on Metal | | | | acetabular fixation. |
| 3) Ceramic on Ceramic | | | | Newer bearing options under investigation is - |
| Metal on UHMWPE provides a low friction bearing | | | | Ceramic on High density Polyethylene |
| surface. The metal component could be Stainless | | | | The choice of bearing surface in a Total Hip |
| steel, or Cobalt-chrome alloy. It produces high | | | | Replacement determines the amount of wear |
| polyethylene wear particles. | | | | particles, risk of third body wear, and the overall |
| Metal on Metal offers the possibility of using large | | | | longevity of the implant; an important decision on |
| size bearing components, with subsequent lower risk | | | | behalf of the operating surgeon. A decision is taken |
| of dislocation, and greater potential range of motion. | | | | based on the joint morphology and the activity level. |