Ceramic Coatings in Metal-PE Joints: Where Are We Now?

Several types of hard coatings were applied onto metallic components in arthroprostheses’ bearings to reduce UHMWPE wear and the consequent wear debris-induced periprosthetic osteolysis, that is still the main problem in arthroplasty. This approach was aimed to obtain in the surface of metal components finish and scratch resistance similar to the ones of alumina ceramic components. Many attempts were made to improve the surface properties of stainless steel, of cobalt-chromium, of titanium alloys and of zirconium alloys. Arthroprostheses’ bearing components coated by titanium nitride (TiN) or diamond-like carbon (DLC), and more recently zirconium-2,5 Nb alloy with a surface layer of monoclinic zirconium dioxide were introduced on the market. This paper briefly reviews the literature on ceramic coatings in prosthetic bearings to assess the today’s status of this technology in arthroplasty.