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Hip replacements are made of different parts.

The stem (portion that goes into the thigh bone)

The head and cup (the bearing surface)

The socket (portion that holds the cup into the pelvis).

The stem is always metal. Usually a cobalt chrome alloy. This may either be coated with titanium or a cermaic such as hydroxyapatite (rough surface) which allows bone to grow onto the stem and hold it fixed in place. Or the stem can be highly polished and cemented in place with polymethylmethacrylate cement.

The socket can either be all polyethylene (usually UHMWPE) and cemented into the pelvis directly (i.e. the cup and socket are one), or the socket can be metal and bond to the pelvis in the same way as the rough stems, with or without the use of screws.

The bearing surface (ball and cup) can vary -

The ball can either be metal or ceramic (alumina), and the socket can either be metal, ceramic or polyethylene (UHMWPE). The polyethylene cups can either be an all in one cup/socket, or a polyethylene liner to a metal socket.

The bearing combinations typically used are:

Metal on polyethylene

Metal on Metal

Ceramic on Ceramic

Ceramic on polyethylene

All have their pros and cons.

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Why does your hip replacement joint squeak?

You should have your hip checked annually with an x-ray to look for wear. Squeaking can also be linked to ceramic on ceramic implants.


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What procedure is involved in hip replacement surgery?

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There are quite a few variables here 1. There are two versions of each. Metal on metal and metal on polyethylene and ceramic on ceramic and ceramic on polyethylene 2. Polyethylene wears out quicker then either metal or ceramic 3. There is currently a massive recall of metal on metal hip implants. These tend to shed minute particles which can cause rejection of the implant and can enter the bloodsream. The plus side for metal on metal is that they can use larger cups (pelvis side of the joint) which means they are less likely to dislocate. Though rate of dislocation will depend on other factors as well e.g. surgical approach used. 4. Ceramic has a long life span but in a few cases makes a horrible squeaking noise and in even rarer cases they can shatter - known as catastrophic failure! Like metal on metal they can use a larger cup size. Ceramic and ceramic is probably now the current favourite If I had to chose I'd definitely go for ceramic on ceramic.


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