Numerous knee implant solutions have been introducing to the market over the years. Orthopaedic companies have continued to develop innovative designs in an attempt to meet patient needs.

Cobalt-chrome-molybdenum (CoCrMo) alloy is currently the most frequently used employed knee implant material on account of its proven characteristics. Recently, however, with the sharp rise in total knee replacement surgery, new materials like ceramic have been proposed.

Many Authors report polyethylene wear as the most frequent cause of aseptic loosening of knee implants, even when correctly placed. Wear particles induce foreign body granuloma that can weaken the bone stock, jeopardising implant stability with the consequence of requiring removal and revision.

Other clinical studies report local allergic reactions to certain metal components of the alloys used for the implants.

pain and progressive limitation of movement. Their radiographic findings revealed joint deterioration and clear signs of implant loosening. Revision surgeries were performed on all 6 cases that had received cartilage implants and a primary total knee replacement was carried out using the Multigen Plus System ceramic femoral component (Lima Corporate).

Currently, all the patients are satisfied with their ceramic implant. None have complained of any discomfort whilst exhibiting a ROM of over 120°. Interestingly, these patients do not perceive their implant as “foreign material” as do

Hypersensitivity may manifest as skin rashes that delay wound healing and can compromise outcomes.

Today knee implants are also available in ceramic, a material widely used for hip prostheses.

Ceramic may be the answer to wear and metal allergy complications. More information will be provided by longer follow-up (currently at 4 years). However, the absence of antigenicity and the considerable reduction in wear observed in hip replacement studies, confirmed by laboratory tests, suggest that Multigen Plus Delta Ceramic femoral components present advantages over metal implants.

The surgical procedure for Multigen Plus Delta Ceramic femoral components is not different to metal and must always be cemented.

Our Centre has implanted 58 Ceramic Knee manufactured by Lima Corporate. Positive outcomes both in terms of mobility and pain confirm the excellence of the design and suitability of the material.

We therefore believe that total knee replacement implants with a ceramic femoral component are a valid alternative to metal ones. In our view this type of implant is particularly indicated for patients with documented metal sensitivity. In addition, the lower wear rate due to the tribologic properties of the ceramic makes this material indicated for young patients where long- lasting implant is a major goal.