A review of metallic, ceramic and surface-treated metals used for bearing surfaces in human joint replacements

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Abstract
A review of established and advanced materials used for the bearing surfaces of total hip replacements (THRs), their standards, methods of manufacture and corrosion testing is presented. Some account is also taken of parallel developments in femoral components used in total knee replacements (TKRs). Metallic, ceramic and surface-modified metallic materials are separately reviewed, but wherever possible common practices are collated. Coated implant bearing surfaces are in an advanced state of development and some designs are receiving clinical evaluation. To date, however, no standard methods of manufacturing and testing these materials have been agreed. Accordingly, corrosion and other key quality test methods suitable for surface-modified implant bearing materials are reviewed.