Abstract
For more than 30 years ceramics are used for heads and acetabular cups of hip joint arthroplasty. The results of wear rates of metal-on-polyethylene, ceramic-on-polyethylene and ceramic-on-ceramic determined from a hip simulator testing were not confirmed when comparing to results of clinical follow ups using either X-rays methods or investigating retrieved implants. There is consensus that the wear couple of metal-on-polyethylene is twice or three times larger than the one for ceramic-on-poly-ethylene. Ceramic-on-ceramic offers the option of 5μm/year. When evaluation novel concepts the best is to investigate retrievals because the hip simulator does not mimic all in-vivo effects. Hip simulator testing is not worse case testing as it should be, hip simulator testing is best case testing. The results may be used for screening purposes.
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