Ceramics have been used for artificial joints since the 1970s when the first alumina device demonstrated better resistance to wear than traditional metal and polyethylenes. Advances in material quality and processing, and a better understanding of ceramic design led to second-generation alumina components in the 1980s. These offered even better wear resistance.

Since then researchers have found that ceramics work exceptionally well in several areas, one being implanted electronic devices.

These increasingly use ceramic components, such as feed-thrus, for interfacing between the device and body tissues. Ceramic-to-metal feed- thrus contain metal pins or small tubes that pass through a ceramic plate. The pins electrically connect the implanted devices so they can sense body functions and deliver an occasional electrical charge. Feed-thrus can also administer drugs. The ceramic substrate of the feed-thru also electrically insulates the pins.

Feed-thrus for implanted devices must be hermetic, with a leak-tight seal around each pin. This ensures body fluids do not get into the device and chemicals do not escape from drug-delivery devices. A brazing material, typically 99.99% gold, joins each metal pin to the ceramic insulator.

Ceramics also improve hip joints. Traditional metal-to-polyethylene hips generate polyethylene debris as they wear. This causes osteolysis which weakens surrounding bone and eventually loosens the implant. This can lead to costly revision operations. Ceramics, on the other hand, generate significantly less polyethylene debris when used with polyethylene acetabular components.

Better yet, state-of-the-art ceramic-on-ceramic technology, in which alumina femoral heads mate with alumina acetabular cups, eliminates polyethylene debris while reducing wear. A study of HIP (hot isostatic pressing) Vitox ceramic-on-ceramic hip joints from Morgan Advanced Ceramics (MAC) showed a wear rate of just 0.032 mm³/million cycles. In addition, these hip joints cannot release metal ions release into the body, a concern with metal-on-metal hips. This wear performance gives ceramic-on-ceramic joints a predicted life of well over 20 years.

Developers of new implantable devices continually demand smaller and more complex components. To address demand, Morgan Technical Ceramics created a one-inch diameter ceramic feed-thru for drug-delivery devices that house 104 separate pins. A signal in each activates different combinations of switches to administer more or complex combinations of drugs.

Powder injection molding (PIM) has furthered the pursuit of smaller components. PIM can make intricate features and unusual geometries, most notably for hearing-assist devices, bone screws, and heart pumps.

Lastly, ceramic-based coatings, such as diamond-like carbon (DLC), provide biocompatible, sterilizable, nonleaching, and wear-resistant surfaces for key pivot points. These coatings reduce friction, increase surface hardness, and prevent ion transfer from metal implants.