Oxidised zirconium heads show a lower linear wear rate than 28-mm metal heads against XLPE: a retrospective analysis.

10 – 13 This has led many surgeons to convert to the use of ceramic heads instead of metal despite an increased economic cost, 14 even though the majority of the evidence indicates there are not lower wear rates with a ceramic head and only a recent meta-analysis indicates a possible trend to lower wear. 13 , 15 – 18 It is also thought that ceramic heads will lower the incidence of mechanically activated crevice corrosion (MACC) or trunnionosis. 19 This is often cited as a major reason for the rise in the use of ceramic heads for primary THA. 20 The risks of using ceramic heads include their brittleness, leading to a relatively high incidence of fracture.

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