Hoskins W, Rainbird S, Peng Y, et al. - This study was sought to distinguish risk factors for breakage and to determine the outcome of different revision options. Between September 1999 and December 2019, all ceramic-on-ceramic primary total hip arthroplasty procedures reported to the Australian Joint Replacement Registry were enrolled. Researchers evaluated the relationship between ceramic type and head size. They compared subsequent revision rates and evaluated the cause of revision. For this analysis, 23,534 alumina and 71,144 mixed ceramic procedures were included. At a 15-year follow-up, ceramic breakage has reduced with mixed ceramics but has a 0.79/1000 incidence. It is not clear what the risk factors are for modern ceramics with elevating head size a risk for alumina only. As per the findings, the risk of 2 ^nd revision is high and occurs early. The optimal revision option is unknown.