ABSTRACT
During total hip arthroplasty, both the femoral and acetabular bearing surfaces are surgically replaced with metallic, polymeric, and/or ceramic components. Throughout the twentieth century, many different combinations of these materials have been explored as candidate bearing surfaces for total hip arthroplasty. Metal-on-metal total hip replacements were first implanted by Wiles in the 1930s (1) and later developed in the 1950s and 1960s by pioneering surgeons like McKee and Ring (2). In 1958, Charnley introduced a ‘‘low-friction arthroplasty’’ based on the principle of a metallic femoral component articulating against a polymeric acetabular component, and in 1970, Boutin developed the first ceramic-on-ceramic total hip replacement (Table 1). Charnley’s hard-on-soft bearing concept eventually dominated the other hard-on-hard bearing alternatives.
