History of this bearing (Ceramic above Ceramic) began 30 years ago in Germany and France. The ceramic bearing has enhanced features that related to friction and wear surface due to very strong, very smooth, capable, capable of a good moisturizing more than any other bearing. Ceramic bearing has the best Tribologih. The initial results were not good since the pioneers of the method attempted to bring direct connection between ceramics and bone. This attempt failed in many cases and has brought loosening and breakage. However, advances in “design” in which the shell that is in contact with the bone is made of titanium and the – Liner ceramic inserted into the titanium, along with the great progress very nature of ceramic, solved the shortcomings of the system. Today, choosing this bearing (Ceramic above Ceramic) is the best for a patient who needs a joint that will be used almost all the time and very active. There are certain structural conditions in the bone of the pelvic that prevent the use in ceramic bearing with taking in consideration its high cost.