The choice of ceramic-on-ceramic coupling in total hip prosthesis has advantages over couplings with other combinations of materials that use polyethylene and metal materials in terms of high hardness, scratch resistance, low wear rate, and increased lubrication performance. To reduce the risk of primary postoperative failure, the selection of ceramic materials for ceramic-on-ceramic coupling is a strategic step that needs to be taken. The current study aims to analyze ceramic-on-ceramic coupling with commonly used ceramic materials, namely zirconium dioxide (ZrO2), silicon nitride (Si3N4), and aluminium oxide (Al2O3), according to Tressa failure criterion for the investigation of the stress distribution. A two-dimensional axisymmetric finite element-based computational model has been used to evaluate the Tresca stress on ceramic-on-ceramic coupling under gait cycle. The results show that the use of ZrO2-on-ZrO2 couplings can reduce Tresca stress by about 17.34% and 27.23% for Si3N4-on-Si3N4 and Al2O3-on-Al2O3 couplings, respectively.

Due to various concerns about the use of metal-on-metal that is detrimental to users, the use of metal as acetabular cup material was later changed to ultra high molecular weight polyethylene (UHMWPE). However, the wear on UHMWPE releases polyethylene wear particles, which can trigger a negative body response and contribute to osteolysis. For reducing the wear of polyethylene, one of the efforts is to investigate the selection of metal materials. Cobalt chromium molybdenum (CoCrMo), stainless steel 316L (SS 316L), and titanium alloy (Ti6Al4V) are the frequently employed materials. The computational evaluation of contact pressure was carried out using a two-dimensional axisymmetric model for UHMWPE acetabular cup paired with metal femoral head under gait cycle in this study. The results show Ti6Al4V-on-UHMWPE is able to reduce cumulative contact pressure compared to SS 316L-on-UHMWPE and CoCrMo-on-UHMWPE. Compared to Ti6Al4V-on-UHMWPE at peak loading, the difference in cumulative contact pressure to respective maximum contact pressure is 9.740% for SS 316L-on-UHMWPE and 11.038% for CoCrMo-on-UHMWPE.

The use of material for implant bearing has a vital role in minimizing failures that endanger implant recipients. Evaluation of contact pressure of bearing material can be the basis for material selection and have correlations with wear that contribute to the need of revision operations. The current paper aims to investigate three different metallic materials, namely cobalt chromium molybdenum (CoCrMo), stainless steel 316L (SS 316L), and titanium alloy (Ti6Al4V) for application in metal-on-metal bearing of total hip implant in terms of contact pressure. In silico model based on finite element simulation has been considered to predict contact pressure of metal-on-metal bearings under normal walking conditions. It is found that the use of Ti6Al-4V-on-Ti6Al4V is superior in its ability to reduce contact pressure by more than 35% compared to the other studied metal-on-metal couple bearings.

Due to polymeric wear debris causing osteolysis from polymer, metal ions causing metallosis from metal, and brittle characteristic causing fracture failure from ceramic in the application on bearing of total hip prosthesis requires the availability of new material options as a solution to these problems. Polycrystalline diamond (PCD) has the potential to become the selected material for hard-on-hard bearing in view of its advantages in terms of mechanical properties and biocompatibility. The present study contributes to confirming the potential of PCD to replace metals and ceramics for hard-on-hard bearing through von Mises stress investigations. A computational simulation using a 2D axisymmetric finite element model of hard-on-hard bearing under gait loading has been performed. The percentage of maximum von Mises stress to respective yield strength from PCD-on-PCD is the lowest at 2.47%, with CoCrMo (cobalt chromium molybdenum)-on-CoCrMo at 10.79%, and Al2O3 (aluminium oxide)-on-Al2O3 at 13.49%. This confirms that the use of PCD as a hard-on-hard bearing material is the safest option compared to the investigated metal and ceramic hard-on-hard bearings from the mechanical perspective.

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