Hip Replacement: Which Materials Are Used?

Dr. Tsao:
Hip replacements are made of many different materials. The thermal component or the piece that goes into the thighbone is generally some sort of metal, cobalt, chrome or titanium and that depends upon the mechanical factors of that particular artificial hip and what type of requirements are needed in terms of that particular hip replacement style.

The socket is again, metal that goes on to the patient’s native bone but the bearing surface, which is the surface that moves, can be made of several different types of material. There’s a metal-on-metal, there is metal-on-plastic, there is ceramic-on-plastic, and there is ceramic-on-ceramic and these various bearing surfaces come in different sizes and they also come in different shapes and different mobilities.

The determination of what type of bearing surface you have is usually made by your surgeon and he or she usually chooses that based upon your size as an in, “Are you 6 ft 5 or are you 5 ft 1?” The size of your particular hip, my gentleman patients have larger hip replacements than they need larger heads, my smaller female patients require smaller heads and that also limits the type of bearing I can choose for them.

The other thing is your age, so younger patients who are in their 40s and 50s may want a hip replacement that could last them as long as possible; 10, 20, 30, 40 years. If you’re an older patient you may be more interested in getting more motion as opposed to having a hip replacement that lasts 40 years. If you’re 85 when you get your hip replacement you may not be too concerned about whether or not your hip replacement lasts 35 to 40 years, but more impressed with the fact that your hip can move in all sorts of directions that perhaps it couldn’t before.

All those things factor into the type of material and the type of hip replacement that is selected for you, and the last thing that also is a big factor is the patient’s anatomy. So somebody who is a dwarf gets a different type of hip replacement than somebody who is Andre the giant, versus somebody who is my height and weight and size, versus somebody who is a little bit larger, and we try and match that according to what you as the patient need. And the surgeon would like to do it to the best degree they can so also the familiarity that that surgeon has with that particular hip replacement is a big factor in what they pick.

About Dr. Audrey K. Tsao, M.D.:
Audrey Tsao received her engineering degrees in Biomedical Engineering and Materials Science & Engineering from Johns Hopkins University. She attended medical school at Cornell University and completed her orthopaedic residency at Northwestern University in Chicago. She returned to Johns Hopkins University to complete a fellowship in Arthritis and Adult reconstruction surgery.

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• Bones & Joints