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Hip replacement materials come down to three families: metal, ceramic, and medical-grade plastic. In my practice, patients want to know what is going inside their body long before they ask about recovery. That is a fair question. After more than twenty years and more than seven hundred hip and knee replacements a year, I can tell you that the material choice shapes how your new hip feels and how long it lasts.
A hip replacement rebuilds a ball-and-socket joint. The parts have to be strong, smooth, and safe to live inside the body for decades. Below, I walk you through each part, the metals and other materials we use, and how I help patients pick the right combination.
What are hip replacement implants made of?
Hip replacement implants are made of metal, ceramic, and a tough plastic called polyethylene. Most modern implants combine these three materials across four parts: a stem, a cup, a ball, and a liner. The metal anchors the implant to your bone. The ball and liner form the new smooth surface that lets your hip glide.
No hip implant is made from a single material. Each part is chosen for the job it does. A titanium stem grips bone well. A ceramic or metal ball resists scratching. A polyethylene liner acts like new cartilage.
What are the parts of a hip replacement implant?
A standard total hip replacement has four parts. Here is what each one does and where it sits.
- Stem: fits down into the femur (your thigh bone) and anchors the implant.
- Cup: sits in the acetabulum (the socket in your pelvis).
- Ball: attaches to the top of the stem and replaces the femoral head (the ball at the top of your thigh bone).
- Liner: snaps inside the cup and becomes your new cartilage surface.
The ball and liner together are called the bearing surface. That is the pair that moves against each other every step you take. Their material matters most for wear.
What metals are used in hip replacement implants?
The main metals in hip replacement implants are titanium and cobalt-chromium. Both are biocompatible, which means the body tolerates them well. Both bond strongly to bone.
Titanium is light and flexes a little like bone. We often use it for cementless stems, where your own bone grows into a textured or coated surface for a lasting grip. Cobalt-chromium is very hard and wear-resistant, so we use it for many balls and for cemented stems.
Some cups use titanium or tantalum, another bone-friendly metal, because bone attaches to them well. Stainless steel is rarely used in modern primary hip replacements; it is softer and now shows up mostly in fracture care.
Here is what I tell my patients: a metal reaction to these implants is far less common than people fear. A nickel rash from cheap jewelry does not mean you will react to a hip implant. If you have a real concern, we talk it through and can plan around it.
What are the most common hip replacement materials and combinations?
The material combination is named for the ball and the liner. Three pairings cover almost every hip replacement I perform.
Metal-on-polyethylene
A metal ball moves inside a plastic (polyethylene) liner. This is the most common and most studied pairing. It is durable and reliable. Modern polyethylene is treated to resist wear far better than the plastic used decades ago.
Ceramic-on-polyethylene
A ceramic ball moves inside a polyethylene liner. Ceramic is very hard and smooth, so it creates little friction. I often reach for this pairing in younger, more active patients who will put more miles on the joint.
Ceramic-on-ceramic
A ceramic ball moves inside a ceramic liner. This pairing has the lowest wear of all. The trade-offs are cost, a small chance of a squeak, and a rare risk that the ceramic can crack.
What is the most common hip replacement material?
The most common hip replacement material is a metal or ceramic ball paired with a polyethylene liner. Metal-on-polyethylene stays the workhorse because it holds up well and has the longest track record.
Cobalt-chromium is the metal I see most often for the ball. Polyethylene remains the standard liner because newer versions wear so slowly. Studies show many hip implants still work well 15 to 20 years after surgery.
Do collared or collarless stems change the outcome?
The stem can be collared or collarless, and this is a detail I weigh for each patient. A collar is a small rim that rests on the cut edge of your thigh bone. It can add early stability and lower the chance the stem sinks into the bone, a problem called subsidence.
Recent research points in a helpful direction. A 2024 review of eleven studies found collared stems had lower revision rates than collarless stems in comparative data, likely because the collar guards against sinking in undersized stems. A collarless stem is often easier to place and to remove if a future revision is ever needed.
Neither choice is right for everyone. Bone quality, your anatomy, and the surgical approach all factor in. This is the kind of decision that reflects experience, not a single rule.
How do I choose the right hip replacement materials?
I choose hip replacement materials based on your age, activity level, bone quality, and any allergy history. There is no single best material for everyone. The right pairing is the one matched to your body and your goals.
Matching hip replacement materials to your lifestyle
A younger, active patient who wants to hike or golf may do better with a low-wear ceramic pairing. An older patient with softer bone may do better with a cemented stem. If you have a documented metal sensitivity, a ceramic ball sidesteps the concern.
I also use robotic assistance in many of my hip replacements, including anterior hip replacement. The Mako® robotic-arm system helps me plan implant size and position with precision, which supports a stable, well-aligned result. As a disclosure, I serve as a paid consultant to Stryker, the maker of the Mako system. You can read more about my approach to robotic joint replacement.
Hip replacement materials and your care in Franklin, Tennessee
If you are weighing hip replacement in Middle Tennessee, I am glad to walk you through the material choices in person. I see patients from Franklin, Nashville, Brentwood, Spring Hill, Columbia, and Nolensville at the Bone and Joint Institute of Tennessee. For a fuller picture of the surgery itself, the American Academy of Orthopaedic Surgeons offers a helpful patient resource on total hip replacement.
Knowing your hip replacement materials helps you ask better questions and feel confident in your plan. Every hip is different, and the best implant for you comes out of a conversation, not a catalog.
Ready to talk about your hip? Schedule a consultation with Dr. Calendine or call the Bone and Joint Institute of Tennessee at (615) 791-2630. We are located at 3000 Edward Curd Lane, Franklin, TN 37067.
This article is for general education and does not replace personal medical advice. Always talk with a qualified orthopaedic surgeon about your own diagnosis and treatment. Individual results vary based on your health, anatomy, and activity level.
References
- Ait-Si-Selmi T, Vidalain JP, Ramos-Pascual S, et al. Outcomes of total hip arthroplasty using collared versus collarless uncemented HA-coated stems: a meta-analysis. EFORT Open Reviews. 2024;9(5):264-275.
- Hutt J, Hazlerigg A, Aneel A, et al. The effect of a collar and surface finish on cemented femoral stems: a prospective randomised trial of four stem designs. International Orthopaedics (SICOT). 2014;38(6):1131-1137.
- American Association of Hip and Knee Surgeons. What Are Hip Replacements Made Of? AAHKS Hip Care patient resource. Revised 2018.
- American Academy of Orthopaedic Surgeons. Total Hip Replacement. OrthoInfo patient resource.
