Higgins JE, et al. - Via involving 211 patients between 2009 and 2011, researchers analyzed noninferiority of a ceramic-on-metal (CoM) articulation compared with metal-on-metal (MoM) in total hip arthroplasty. Study participants were randomized to ceramic or metal. According to this prospective, multicenter, randomized, controlled trial, no significant difference was observed at any time point in patient demographics, radiographic parameters, or functional outcomes. At all time points, lower cobalt ion levels have been seen in the CoM group. The findings showed that in terms of functional outcome and radiographic parameters, the CoM articulation remained the same as the MoM. In addition, the CoM coupling shows raised metal ions beyond 3 years and increasing revisions for adverse reaction to metal debris. A clinical application for CoM remains difficult to see and further exploration or use is not justified.