Titanium vs. Ceramic – The Next Big Battle in Health Care? Part One

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Guest contributor Alex Burns studies biology at Cardiff University in the UK.

You’ve heard of Car Wars – now how about Titanium vs. Ceramic?

What did ceramic say to titanium?

Move over. More and more now, ceramic composites are used in hip replacement in favor of titanium. The hip replacement is one of the most successful and widely done operations around the world. 90 percent of patients report pain-free movement, and a wider range of mobility. How is this miracle performed?

Doctors completed the first hip replacement in 1891 with the use of ivory, but they soon moved on to metals. With the invention of Teflon, the wear and tear along with the metal build-up in the bodies of the patients was reduced until modern alloys were introduced. These days, the typical metal femur head replacement consists of a titanium stem attaching to the femur and a cobalt chromium head for hardness. The head is machined to size and then polished to reduce the rubbing on the bone. Not too long ago a plastic spacer of polyethylene was put between the head and the socket to further reduce wear, but it was found the cobalt chromium head lasts longer on its own.

How long does a hip replacement last?

The average hip replacement lasts around 25 years, but with the usage of ceramics this could be lengthened even further. The main cause of a revision hip replacement is wear and tear; the heads grind down over time, causing a build-up of material which is related to loosening of the joint and a return in pain along with a loss of mobility.

Ceramic implants, however, are much smoother and harder than their cobalt chromium counterparts and so wear less. That’s one of the reasons they’re used in high performance brake pads on cars. For younger patients receiving hip replacement, this could be a massive bonus. If they got a metal implant at the age of 45, by the time they were 70 it would need revision surgery at a stage in life where their bodies are far less able to heal and deal with any complications associated with the surgery. With a ceramic head, the implant should hopefully outlast them and so rid them of the necessary operation to change it.

Continued in Part Two.

–Alex Burns

Comments (23)

  1. Andre says:

    I certainly hope the wear of the ceramic implant far outlasts traditional metal. I had my hip replaced last year at only 46 years of age. I really don’t want to have a revision.

  2. Kate says:

    I second that. I had a bilateral hip replacement this year at age 48. Really don’t want to have to relive this experience again.

  3. Cheryl says:

    I had the titanium one put in at the age of 23 in 1985. Have had no problems, delivered two babies and worked on my feet for 10 years. It will be 28 years this August and I’m hoping for it to last for a long time. My motto is “use it but don’t abuse it”.

  4. Dave says:

    I have just had a full hip replacement with ceramic I am 48,I am hoping that I can get many years of normal quality of life. I am still on medication still nervous as regards taking it easy not bending,moving and twisting so any more advice would be welcome.

  5. Melissa says:

    Ive had 4 surgeries on my right big toe. Last 1 took out my titanium implant & inserted plastic. Ive got severe heavy metal allergies, very rare. Im now looking for a doctor in pittsburgh to do my hip replacement & cant find one. Any advice or thoughts, i would travel if needed.

    1. Jeff Yoders says:

      Hey Melissa,

      First off, good luck in your search. There are options for those with metal allergies. We’ve also covered some innovative uses of non-metallic prosthetics such as polycarbon. We hope that you can find the best solution for you.


      Jeff Yoders,

  6. patrick Fitzgerald says:

    Me so scared, I had total hip replacement 2013, developed foot drop. I couldn’t return to work, bartender by trade. Now I find out I have an infection from prosthetic device which was probably brewing inside me since the beginning, I never had follow up doctor work because of insurance issue, now I wait for Social Security Disability to help, but that’s timely procedure. I hope the infection doesn’t find its way to the blood stream? when I had this done I was 48 hoping to be a new man, now I am 53, sad and depressed. Mine was Makoplasty robotic THR if this information helps anyone. I recommend the robot not to be used!

  7. Carole Jupp says:

    I had 2 hip operations with titanium prothesis inserted in 1992 at the age of 49 and still have good use of both hips with only slight discomfort now and then. Played Golf for 20 years after op and still play Bowls even though I have Osteoarthritis in all of my joints.

  8. Frank Decrescenzo says:

    Just was released from right hip replacement surgery. Told my materials used were ceramic and titanium. Is this good?

  9. Delores Dowling says:

    Titanium causes corrosion.

  10. Lori says:

    What are some names of ceramic TKR total knee replacement devices materials for non-constraint, semi and constraint. I am not sure if my ligaments and muscles can support the prothstesis or not. I am having TKR February 4th, and would like to know the best ceramic options. I may need hip replacement in the future and would like to discuss my options with my physician ahead of time. Definitely requesting head of anesthesiology anesthetize me. I called the physician’s office to find out how many operations he had performed and their success rates to calm my concerns after confirming he was orthopedic surgeon who is board certified.

  11. ghazali says:

    I am asking because i have to go very soon for the total hip replacement surgery at the age of 41 , what is the best type of artificial hips I should plant ( Metal on Metal – Ceramic on Ceramic)?

    your help is highly appreciated.as I don”t want to make the operation for a second time in my life.

  12. Kathleen Smith says:

    I had a titanium plate at C6-7, soon afterwards I would wake up with hands that were painful and stiff. I went back to doctor, he Xrayed and said the position was perfect and recommended a right carpal and cubical tunnel release, with little improvement. I have had a miriod of symptoms which has left me disabled. I wonder if I could be allergic to the metal or the alloys they use. In Europe all implants are tested to se if the patient is sensitive to them.

    1. Leah says:

      I had a Titanium hip replacement on both hips 2010 at the age of 46 due to severe osteoarthritis. I had the first hip replacement on September 2010 and the other December 2010. I was not ask if I was allergic to any metals. Now my chromium and cobalt levels are high. My legs are pain and swollen and hard to walk on. Recently saw my old surgeon he says it is just bursitis continue rehab and your labs does not matter as long as your MRI says your hips or intact. Rehab is not working. I got a second opinion and he stated your labs do matter. He stated high chromium and cobalt levels will lead to other complications. My first surgeon never mention my hips are recalled I found out by accident. My second opinion surgeon stated I need the brand of titatium removed because it is going to get worse. I can barely walk because of the pain. I heard and read that second replacement don’t go well. I’m scared to death. Bad if you don’t do a second hip replacement and bad if you do. What to do? Help!

  13. Gerry Levasseur says:

    I have had both hips replace . One 7 years and the other 5 years so far no real problems other then always being very sore on my right one were they made the insision. I hike play golf and ski. I am 72 years old. Both are titanium.

  14. Margaret Williams says:

    I had total hip replacement in May 2020. I don’t know what was used during surgery… I just hope it last rest
    of my life time as I am 76 years young
    and it was a very painful experience. The doctor was wonderful and knew
    his hip replacement thing. It was done and over in a couple of hours. The
    horrific pain went into the waste with the ole hip. I just wonder how much
    longer my hip will have pain and aches after the surgery. Follow up Xrays look normal so I cannot figure what’s causing the the discomfort.
    Has anyone experienced this issue? What can I expect, you think?

  15. Anne Oliver says:

    It’s getting better by 6 weeks, then gradually each month til six months, fully better by 12 months. It’s a major operation, be patient!

  16. Barbara E Hampton says:

    I had a titanium hip replacement about eight weeks ago and I study ballet. so I was trying to find out if the titanium hip had the ability to rotate.

    The one reply I saw above mention titanium rusts or disintegrates easy that’s a little alerting to me, and I thought titanium was the latest and greatest and now I’m reading all this information about ceramic lasting longer than titanium and they’ve been doing them for years so I can’t figure out why my great orthopedic did not give me the latest and greatest especially when he knows I study ballet. I am 69 years old.

  17. Betty Hofmann says:

    Needing a hip replacement. Where do they do ceramic on ceramic? What are the names of some good orthepedics? I have allergies to metals, please help.

  18. Frank Bressett says:

    Had both done at 61 and 62 in2018 and 19 rt is fantastic left verydisapounted in25months they have no answer to my pain seeking 2nd oppion in march2021cannot and will not live out my life like this also had back surg was told my pain was from nerve damage in my leg did nothtng ti heip just upped my minor back pain my question to you is can I advocateto get my hip replacement replaced??as I am a very young active 64 yr old male and this hip has made my lifeheii

  19. Inaiya Ray says:

    I am allergic to metal and looking for a surgeon who does ceramic hip resurfacing…in the US or willing to travel. Thank you for your suggestions.

  20. Kimberly Suzanne Moore Prescott says:

    I am totally freaked out! At 38 years old I was hit by a car. I’m 52 now and they are recommending 2 full hip replacements because the years of medication degenerated all of my joint cartilage…?! wtf
    It makes it so hard for me to trust the decision. I’m in constant pain. I’m gaining weight (60lbs in the 13 years), I’m depressed, I’m homeless in a questionable RV. The accident has caused me to lose most of everything I had. I’m on medi-cal so probably don’t qualify for ceramic. My ears don’t even like the metal in ear rings. My teeth have even pushed out fillings. I really don’t like the idea of metal inside me. Scared

  21. Louise says:

    I had right hip replaced aged 41 and I’ve just had my left hip replaced aged 43. Neither are ceramic so I hope to god I don’t need either replacing again in my life time. I couldn’t cope!

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