Metal on Metal Total Hip Arthroplasty

Ceramic on ceramic has been shown to have a theoretic increased risk of fracture compared with cobalt chromium. Newer aluminous ceramics are being produced with lower porosity and grain size, resulting in lower fracture risk but still greater than that of cobalt Chromium. There is no correlation between metal serum levels and cancer risk as such the link between metal on metal arthroplasty and an elevated cancer risk has not been supported by hard data. The correct answer to this question is three, increased fracture toughness. Four, decreased surface roughness. Five, lower coefficient of friction.