For the past 20 years, femoral heads have been successfully employed f
or modular total hip prostheses. To date, some 2 million ceramic femor
al heads have been implanted, mainly in Europe, but also in North Amer
ica and Japan. The majority of these are BIOLOX heads having a diamete
r of 28 mm and with the so-called European taper 12/14. The most impor
tant properties and the arguments in favour of using alumina ceramic f
or total hip prostheses are outlined, and safety aspects discussed. So
me secondary requirements for these systems with ceramic cups or cup i
nserts, which are now meeting with increased interest, are considered.