What is known about ceramic-on-ceramic wear and its most common complication?

• A. Very high wear.
• B. Very low wear; risk includes ceramic fracture, chipping, edge wear and audible squeaking; ensure proper component matching and alignment to minimize.
• C. No wear at all.
• D. Only squeaking.

Answer: (B)

Ceramic-on-ceramic bearings wear very little compared with other bearing pairings, which is a major advantage for long-term debris reduction and osteolysis risk. But they carry their own set of potential problems tied to the ceramic material. The most notable issues are the risk of ceramic fracture or chipping, especially if the component is subjected to trauma or if there are flaws or edge loading. Edge wear can occur when the components aren’t perfectly matched or are misaligned, leading to wear at the rim. Audible squeaking is a common patient-facing complication that can arise from lubrication dynamics and certain hip positions or movements, even though the overall wear remains very low. To minimize these risks, precise component matching and correct alignment during implantation are essential, along with careful soft-tissue balancing to avoid impingement.