Wear debris contributes to the development of granulomatous debris disease and loosening. It is accepted that hydroxyapatite ceramic (HA) will bond a prosthesis to bone.[1,2] Osteolysis has not been seen for several years after implantation but cases are now emerging . Is HA still working? Should we use hard on hard bearings? Should we abandon polythene liners? With a modular hip system, patients with polythene acetabular liners have been compared with those with ceramic liners. Polythene liners wear out and patients with a life expectancy of more than ten years should have ceramic/ceramic bearings.