When a patient is determined to undergo artificial joint replacement surgery, he or she is often troubled by the choice of which prosthesis to choose, wondering whether he or she should choose a ceramic-to-ceramic prosthesis or a metal-head-to-polyethylene lined prosthesis. It should be noted that the stem and outer cup of the hip prosthesis are mainly made of titanium, and the femoral head placed in the proximal femur is divided into ceramic or metal head material; while the lining material inside the metal outer cup of the acetabulum is divided into ceramic or polyethylene material. The standard configuration of the artificial hip joint is a metal head with a polyethylene lining, which has been used for many years with good clinical results, and most of them (85%) can be used for more than 20 years. However, analysis of the causes of joint prosthesis failure after a certain number of years of use revealed that periprosthetic osteolysis is the most important cause of prosthesis loosening. The occurrence of osteolysis is related to the abrasion of the polyethylene by the metal head: the microscopic polyethylene particles trigger an immune response in the body. After a certain number of years of use of the metal head on the polyethylene joint (usually 10-20 years), microscopic particles of polyethylene are dispersed around the joint cavity prosthesis (acetabular and femoral prosthesis), and the body reacts to these particles, considering them as foreign substances, triggering a sterile inflammatory response in the body. However, just as plastic is difficult to decompose, these particles are very difficult to dissolve, and the macrophages swallow more and more particles and secrete more and more lysozyme, to a certain limit, the macrophages will rise and die, releasing all kinds of lysozyme into the tissue around the prosthesis. These lysozymes are not able to dissolve the polyethylene particles, but when they are released into the tissue, they are able to dissolve the normal tissue. This causes the bone tissue around the prosthesis to dissolve, and in the long run, the bone around the prosthesis dissolves more and more heavily, and the firm fixation of the prosthesis to the bone tissue is damaged, and the prosthesis loosens, and the artificial joint fails and requires an artificial joint revision. Ceramic-to-ceramic joints can avoid the above problems to the maximum extent: 1, ceramic-to-ceramic greatly reduces the wear particles, ceramic is one of the most wear-resistant materials of all materials, wear is very small, so the generation of particles is less. 2, Ceramic to ceramic wear particles are highly biologically inert, meaning that their particles cause very little body reaction and rarely cause significant osteolysis, thus reducing the likelihood of prosthesis loosening. It should be noted that the biggest problem with ceramic-to-ceramic is that it is weaker against impact than metal head-to-polyethylene, which can potentially cause ceramic fragmentation. Such fractures are rare (a fraction of a million), and as long as the prosthesis is placed correctly and high intensity impact is avoided, ceramic fracture will not usually occur. In the nearly 1,000 ceramic-to-ceramic cases I have personally performed, I have not had any problems with ceramic fracture. Ultimately, the majority of metal head-to-polyethylene lined joints will last more than 20 years, and ceramic-to-ceramic joints should last many more years than metal head-to-polyethylene joints. Therefore, the extra $10,000 spent for at least 5 more years of use is well worth the money.