The contact conditions and the resulting contact stresses for ceramic on ceramic pairings with diameter 28, 32 and 36mm were determined. A hip simulator according ISO 14242 was used to measure the wear behaviour of these hard – hard couplings in comparison with the common hard – soft pairing ceramic on polyethylene. It was found that there isn’t a significant dependence of the wear behaviour from articulation diameter for ceramic on ceramic but a strong increase of polyethylene wear with larger hip joint heads.