Ceramic bearings were approved for use in the US by the FDA in 2003. These types of implants have been used outside the United States for over 20 years. While the early designs were subject to wear, breakage and failure, newer ceramic bearings have much better wear resistance with a very small incidence of breakage. Ceramic bearings have very low friction and wear and produce no adverse ions or particles. Currently the risk for fracture and catastrophic wear is low; however, breakage of this type can lead to major hip implant failure and difficulty with revision. In addition, if it becomes necessary to remove one of the ceramic parts, ceramic cannot be used for the revision. In my practice, ceramic bearings are used for women of child-bearing potential and in patients with metal sensitivities or allergies.