Hip Replacment Implant Options

Doctor holding a hip replacement implant
Peter Dazeley / Getty Images

Hip replacements are among the most common orthopedic procedures. When a hip replacement is performed, the arthritic, damaged hip joint is removed. The ball-and-socket hip joint is then replaced with an artificial implant. The materials used in the implant depend on different factors, including:

  • Age of the patient
  • The activity level of the patient
  • Surgeon's preference
  • Particular deformities/abnormalities of the hip

Here are brief descriptions of some of the most commonly used hip replacement implants. Not all implants are options for all patients.

Metal and Plastic Implants

A prosthetic made of metal and plastic are the most commonly used hip replacement implants. Both the ball and the socket of the hip joint are replaced with a metal implant, and a plastic spacer is placed in between. The most commonly used metals used include titanium and stainless steel. The plastic is called polyethylene. The implant is secured to the bone by one of two methods; it is either press-fit or cemented into place. In the press-fit method, the implant is fit snugly into the bone, and new bone forms around the implant to secure it in position. When an implant is cemented, a special bone cement is used to secure the prosthesis in position.

New implants are continually being developed in an effort to make these implants last as long as possible. One more recent development is improving the longevity of the polyethylene used in the replacement. These so-called 'highly cross-linked' plastics are manufactured in a way that they wear out less quickly than the traditional plastics.

Metal-on-Metal Implant

Metal-on-metal implants use similar materials, but there is no plastic spacer inserted between the implants. Metal-on-metal implants became very popular because they were found to have very good wear characteristics in the lab. However, despite the low wear rates, there were problems with the metal-on-metal implants.

Initially, there were concerns about the wear debris that is generated from the metal-on-metal implants. Metal ions are released into the blood, and these metal ions can be detected throughout the body. Concentrating these metal ions increases over time. There are no data to show that these metal ions lead to increased rates of cancer or disease, but longer-term studies still need to be performed.

In addition, there were some highly publicized recalls of metal-on-metal implants because they were shown to require revision surgery (replacement of the replacement) at a higher rate than standard hip replacement implants. As a result of this, metal-on-metal implants have gone from being a very popular type of implant to a very rarely used type of implant.

Ceramic Implants

Ceramic hip replacement implants also use metal parts that fit within the bone, but the bearing surface (the ball and the socket) can be made of the ceramic material. Ceramic hip implants are designed to be the most resistant to wear of all available hip replacement implants. They wear even less than the metal-on-metal implants. Ceramics are more scratch-resistant and smoother than any of these other implant materials. Older versions of ceramic implants had problems because they were prone to breakage, but the newer versions have not had these problems. For this reason, ceramic hip replacements are becoming a more popular implant.

Which Is Best?

There is no clear best implant. While new implants are being developed to improve upon designs, there are sometimes problems that aren't known as soon as a new implant is released. For that reason, some surgeons prefer an implant with a good, long track record. Your surgeon should be able to clearly explain why they are recommending a particular implant for you.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Merola M, Affatato S. Materials for Hip Prostheses: A Review of Wear and Loading ConsiderationsMaterials (Basel). 2019;12(3):495. doi:10.3390/ma12030495

  3. Hu CY, Yoon TR. Recent updates for biomaterials used in total hip arthroplastyBiomater Res. 2018;22:33. doi:10.1186/s40824-018-0144-8

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.