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No additional wear is produced compared to a 28 mm ceramic bearing couple. In revision endoprosthetics, a special ceramic femoral ball head system (BIOLOX®OPTION) made of the mentioned ZTA-ceramic (BIOLOX®delta) has been developed which consists of a thin-walled ceramic femoral ball head and a metal sleeve. This system provides a secure possibility of replacing a ceramic femoral ball head in a revision surgery without the need of replacing the stem. The ball head system offers a safe solution for the rare case of ceramic component fracture and expanded applications for primary surgery [95–97].

Annual Report 2008 40 3 M. Kuntz et al. 79. : Wear performance of 36 mm BIOLOX® forte/delta Hip combinations compared in simulated “severe” micro-separation test mode. D, Billau, K. ) Bioceramics and Alternative Bearings in Joint Arthroplasty, Steinkopff-Verlag Darmstadt, 33–43 (2007) 80. : Long-term wear of ceramic-matrix composite material for hip prostheses under severe swing phase microsimulation. J. Biomed. Mater. Res. Appl. Biomater 66B, ­567–573 (2003) 81. , Patient Activity after Total Hip Arthroplasty Declines with Advancing Age.

Am. 85, 20–26 (2003) 88. : Late dislocation after total hip arthroplasty. J. Bone Joint Surg. Am. 84, 1949–1953 (2002) 89. : The new demands by patients in the modern era of total joint arthroplasty: a point of view. Clin. Orthop. Relat. Res. 446, 146–152 (2008) 90. : Wear of polyethylene acetabular components in total hip arthroplasty. An analysis of one hundred and twenty-eight components retrieved at autopsy or revision operations.  Bone Joint Surg. Am. 79(3), 349–358 (1997) 91. : Polyethylene wear in Scanhip arthroplasty with a 22 or 32 mm head: 62 matched patients followed for 7–9 years.

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