Factors influencing the reliability of ceramic femoral components

The longevity of ceramic components implanted in the human body is controlled by a number of factors associated with their design, manufacture and interfacing with metallic components, as well as factors associated with the surgical implantation and patient use. While the technology can be considered to be mature, it requires maintenance of optimum materials and processes on the part of the ceramic manufacturer, as well as achieving optimum potential performance and failure risk reduction through design, commensurate with achieving practical goals. This paper reviews the issues of performance requirements, and the relevance of standardised tests for both the material and the components compared with in vivo loading. Long-term testing to determine resistance to static loading is described. Fractography is shown to be a key element for interpreting failure modes and mechanisms.