Metal vs Ceramic vs Plastic: Does The Type Of Implant Matter In Total Joint Replacement?

Joint Replacement Implant Options

Total joint replacement (TJR) surgery is commonly performed in the United States. Roughly 750,000 total knee replacements and over 450,000 hip replacements are completed yearly. Joint replacement surgery is often performed as a long-term solution for arthritis or joint damage to the hip, shoulder, knee, or wrist. Patients can choose from metal, ceramic or plastic implants when undergoing arthroscopy.

When to consider arthroplasty

Typically, a person is considered a good candidate for the procedure if relief isn’t achieved with non-invasive solutions or progressive damage further weakens the joint. Along with arthritis and fractures, poor blood supply to the bone can be a reason to get the surgery. To optimize joint durability and surgery success, different materials may be considered. Popular options are metal, ceramic, and plastic, but many surgeons opt for a combination of the materials depending on a patient’s age, activity level, joint damage, weight, and allergies.


Of all the combinations, a metal and polyethylene combination is considered one of the most durable choices for joint replacement. Polyethylene is a specific type of plastic. The blend can feature a metal ball with a plastic socket or lining for hip replacement surgery. As strong as the option is, this combination is known to produce debris that can encourage osteolysis or the destruction of bone tissue. The implant can also fail over time.


When a patient selects a ceramic-on-ceramic implant, the entire replacement is made from ceramic material. This match has been considered ideal for hip replacements since the 1970s when the materials were first introduced. Compared to other material choices, an all-ceramic joint has higher longevity with a lower risk of deterioration in the surrounding bones. Likewise, this implant is less likely to dislocate or require future corrective surgeries. The main drawback is that ceramic-only joint replacement surgery can be expensive. This option is also more likely to lead to squeaking during movement.


Another option for total joint replacement is ceramic with plastic. Both materials offer great longevity, while the combination joint design helps to reduce the cost versus an all-ceramic implant. Additionally, the plastic integration means the patient experiences less friction, and the joint undergoes less wear and tear over time.

Understanding the options

The individual solution recommended for a total joint replacement candidate will depend on the joint that’s being replaced. For example, whereas an all-ceramic joint might be considered for a hip replacement, this option may not be preferred for a total knee replacement due to concerns about brittleness. A person’s budget will also influence the recommended implant option since plastic is the most affordable, whereas ceramic is considered the most expensive. Individuals considering arthroplasty should speak with a surgeon to understand the potential options and determine the best solution.


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