Is there any difference between the various friction surfaces and each other? Metal to polyethylene plastic is the most common friction surface used, with 150 to 200 microns worn off per year, while ceramic to plastic is relatively slow to wear, with close to 90 microns per year, and ceramic to ceramic is very slow to wear, with less than 5 microns per year. What kind of patients are suitable for each of these different types of friction surface matching? Patients under 60 years of age, who are expected to live for more than 30 years in the future, are best served by ceramic-to-ceramic prostheses, while patients over 60 years of age are more economically suited to ceramic-to-polyethylene plastic prostheses. Will ceramic prostheses shatter? However, the chance of a ceramic joint breaking during normal use is about 1 in 10,000, so there is basically no need to worry about ceramic breakage. What is the difference between third-generation and fourth-generation ceramic joint prostheses? IV ceramic is more wear-resistant and less likely to shatter than III ceramic.