Ceramic coatings deposited on orthopedic implants are an alternative to achieve and maintain high wear resistance of the metallic device, and simultaneously allow for a reduction in metal ion release. Silicon nitride based (SiNx) coatings deposited by high power impulse magnetron sputtering (HiPIMS) have shown potential for use in joint replacements, as a result of an improved chemical stability in combination with a good adhesion. This study investigated the effect of N, C, Cr, and Nb content on the tribocorrosive performance of 3.7 to 8.8 µm thick SiNx coatings deposited by HiPIMS onto CoCrMo discs. The coating composition was assessed from X-ray photoelectron spectroscopy and the surface roughness by vertical scanning interferometry. Hardness and Young’s modulus were measured by nanoindentation and coating adhesion was investigated by scratch tests. Multidirectional wear tests against ultrahigh molecular weight polyethylene pins were performed for 2 million cycles in bovine serum solution (25%) at 37 °C, at an estimated contact pressure of 2.1 MPa. Coatings with a relatively low hardness tended to fail earlier in the wear test, due to chemical reactions and eventually dissolution, accelerated by the tribological contact. In fact, while no definite correlation could be observed between coating composition (N: 42.6–55.5 at %, C: 0–25.7 at %, Cr: 0 or 12.8 at %, and Nb: 0–24.5 at %) and wear performance, it was apparent that high-purity and/or -density coatings (i.e., low oxygen content and high nitrogen content) were desirable to prevent coating and/or counter surface wear or failure. Coatings deposited with a higher energy fulfilled the target profile in terms of low surface roughness (Ra < 20 nm), adequate adhesion (Lc2 > 30 N), chemical stability over time in the tribocorrosive environment, as well as low polymer wear, presenting potential for a future application in joint bearings.