Advantages of ceramic-ceramic articulating surfaces over metal-metal articulating surfaces. Many younger patients use 28mm and 32mm metal bulb heads with thinner polyethylene liners. This joint mating is the result of the US industry leading the market a decade ago. After less than a decade of use, this thinner polyethylene liner underwent severe wear and massive osteolysis, a disastrous consequence for which many young patients had to undergo early revision arthroplasty, resulting in significant economic problems for the patient and society, and generally poorer joint function after revision than after initial arthroplasty. In addition, the ceramic-ceramic articulating surface prosthesis is a single-cup acetabular prosthesis, in which the socket liner is pre-positioned in the socket cup, thus reducing the risk of intraoperative cup and socket liner assembly. Huiliang Shen, Department of Orthopaedics, Xuanwu Hospital, Capital Medical University Current rationalization of hip disease selection is based on the following grouping and treatment measurements: A. Elderly, low need metal-polyethylene ~Larger ball head reduces risk of dislocation ~Plain polyethylene vs. high hinge polyethylene -No risk of ion release -Rarely fragmentation -Moderate price B. Elderly, moderate or high need patients Metal-high hinge polyethylene ~No risk of ion release ~Rarely shatters ~Moderate price ~Low wear C. Young, active women of childbearing age ①Consider ceramic-ceramic or ceramic/metal-high-hinged polyethylene ②Avoid metal-metal (the effects of metal ions on the fetus are not conclusive) D. Young, active men or non-reproductive women Metal/ceramic-high-hinged polyethylene Metal-polyethylene ~Risk of metal ion release Reduced ~metal-metal available with large head and no risk of fragmentation ~Note: Metal-metal can undergo ALVAI reaction. More common in women E. Young, active patients but with renal disease or allergy to metal ions ~consider ceramic-ceramic or ceramic/metal-highly articulated polyethylene ~avoid metal-metal (risk of ion release)