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News, Trends, and Insights from the World of Hip and Knee Replacement and Beyond

Read up on the research transforming total joint arthroplasty – and the BIOLOX® ceramic components shaping the future of patient care. 

BIOLOX delta ceramic head in ceramic liner (left) and in polyethylene liner (right) on dark background

Additional evidence for BIOLOX® delta bearings: nationwide Korean data on 15,299 total hip arthroplasties

In Archives of Orthopaedic and Trauma Surgery, Lee et al. (2026) analyzed the Korean National Health Insurance database. They compared two bearing options: BIOLOX®delta ceramic-on Ceramic (DoD) vs. BIOLOX® delta ceramic-on-highly cross-linked polyethylene (DoHXLPE).

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Clinical results title graphic with a stylised hip resurfacing implant.

Glass molds in the 1930s. Teflon cups in the 1950s. Metal-on-metal in the 1990s. Ceramic-on-ceramic today.

A 2026 review in HIP International traces a century of hip resurfacing and what each generation taught surgeons.

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Exploded view of a femoral stem taper, ceramic head, and ceramic acetabular liner.

Ceramic-on-ceramic vs. polyethylene-bearings in THA: what can 120,000 hips tell us?

A new meta-analysis by Dr. Lee Rubin (Yale University) et al. in the European Journal of Orthopaedic Surgery & Traumatology pools 33 comparative studies (randomized controlled trials and observational cohorts) encompassing more than 120,000 primary THAs.

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Close-up of the Japanese flag featuring a red sun disc and the word “Registry”.

90.8% of femoral heads used in Japanese primary hip replacements last year were ceramic. 77.8% were BIOLOX®delta.

That is what clinical trust looks like at scale.

To mark the occasion, we are sharing real-world data from Japan, one of the largest hip arthroplasty markets in the world.

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CoP ceramic liner and MoP metal femoral head in polyethylene cups; labeled Clinical Results comparing bearing surfaces in primary THA.

Bearing choice and PJI risk: Evidence from a 10,602-patient THA cohort (Rothman Orthopaedics)

Periprosthetic joint infection (PJI) remains a devastating potential complication following total hip arthroplasty (THA). While bearing surface selection has traditionally been discussed in the context of wear and long-term survivorship, a growing body of research suggests that implant material may influence the local immune environment – and even pose the risk of infection.

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BIOLOX®delta CoC monoblock acetabular cup with titanium mesh shell alongside a ceramic-on-polyethylene modular cup; labeled Clinical Results.

BIOLOX®delta ceramic-on-ceramic monoblock vs. ceramic-on-polyethylene modular: what 5 years of radiostereometric analysis reveal for ceramic hip replacement

Drs. Caner Içli and Nina M. C. Mathijssen, together with colleagues at the Reinier Haga Orthopaedic Centre and Reinier de Graaf Gasthuis (Netherlands), have published a new randomized controlled trial in Acta Orthopaedica.

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Pink BIOLOX delta ceramic femoral head and acetabular liner on black background, labelled Clinical Results.

BIOLOX®delta - 4th-generation ceramic-on-ceramic bearings, stability, and low complication rates: a study of 10+ years

A new prospective multicenter study by Lee et al. (University of Gwangmyeong Hospital and others in South Korea) in the Journal of Arthroplasty reports minimum 10-year outcomes of cementless total hip arthroplasty (THA) using 32/36mm BIOLOX®delta CoC bearings (Zimmer Biomet stem/cup system).

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What does the best available evidence tell us about BIOLOX®delta 4th-generation ceramic bearings in total hip arthroplasty?

Profs Carsten Perka, Luigi Zagra, Maziar Mohaddes, Niklas Keller, Axel Ekkenkamp, and Dirk Stengel – hailing from institutions including Berlin’s Charité Medical University Center and Milan’s IRCCS Istituto Ortopedico Galeazzi – are the authors of one of the most comprehensive best-evidence synthesis to date. It draws on eight national registries, 20 systematic reviews, and over two decades of clinical use and real-world data to provide unbiased estimates of advantages and potential risks of 4th-generation ceramic bearings in THA, with a focus on BIOLOX®delta.

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3D render of a BIOLOX® ceramic femoral head and acetabular insert as a ceramic-on-ceramic bearing pair, labeled Clinical Results

Ceramic-on-ceramic tribology is a system & technology question – not a material question alone.

CoC bearings have proven their long-term stability and performance in total hip arthroplasty. But what do we know about the mechanisms behind frictional instability, lubrication transitions, and microstructural damage? A research team at China’s Zhejiang Institute of Medical Device Testing set out to consolidate the current evidence.

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