Ultra-short pulsed laser irradiation with a fluence H of 3.7 J·cm−2, pulse duration τ of 220 fs and 50 shots per spot affected a special and unique combination of surface features on a-C:H coated medical grade CoCrMo. The average dimple depth was calculated to be 5.09 ± 0.41 μm, which is much deeper than the a-C:H coating thickness of 2.5 μm on CoCrMo. Laser induced periodic surface structures (LIPSS) were generated on sections of the bottom of each laser dimples. LIPSS are considered to have an antibacterial effect. As proven by Raman spectroscopy, a small region at the edges of the laser dimples is graphitised only. During sliding of a (CrN + a-C:H) coated ball against the μ-patterned a-C:H coated CoCrMo, graphitised fractions determined the friction and wear under dry conditions. Using hyaluronic gel as a lubricant, the coefficient of friction was 0.08 and showed a uniform curve over the sliding time. Furthermore, the round laser dimples with a distance of 60 μm served as lubricant reservoir. The DLC coated balls are more sensitive in hyaluronic gel and showed the higher wear rate of 2.67 · 10−7 mm3/N·m, which is the highest wear rate measured during this study. On the contrary, the CoCrMo with μ-patterned DLC revealed a wear rate of 0.40 · 10−7 mm3/N·m only, if there is hyaluronic gel lubrication.