In total hip replacement, the most common bearing surface combination that provides the best wear characteristics and lowest revision rate in young, active patients (<55 years) as per current guidelines is:

• A Metal-on-polyethylene (MoP)
• B Metal-on-metal (MoM)
• C Ceramic-on-polyethylene (CoPE)
• D Ceramic-on-ceramic (CoC) ✓

Explanation

Ceramic-on-ceramic (CoC) bearing surfaces have the lowest wear rates (<0.001 mm/year), generating minimal debris and avoiding metallosis or polyethylene particle-induced osteolysis — making it the preferred choice in young, active patients who require high-demand, long-lasting implants. MoM bearings were found to cause elevated cobalt/chromium ions in blood (pseudotumors, ARMD — adverse reaction to metal debris) and are now largely abandoned. MoP generates polyethylene debris causing osteolysis over time. CoPE (highly cross-linked polyethylene) reduces wear compared to conventional PE but does not match CoC. The known disadvantage of CoC is the rare phenomenon of squeaking.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.