Ceramics, Cobalt Chromium, Titanium, Ceramic Coatings, and Polyethylene are all used in modern hip and knee replacement and resurfacing procedures. All the materials have a role but they are not equally useful for each purpose and in each patient. Wear and resistance to oxidation and corrosion are also important aspects of each material. Resistance to abrasion is an important and so far under emphasized feature. It is important to have high resistance to abrasion to limit the generation of wear debris with use. Dr. Pritchett from the hospital operating room demonstrates the abrasion resistance of the materials commonly used in joint replacement and resurfacing procedures. Titanium Nitride Coated implants show superior abrasion resistance and therefore will be the most biocompatible under heavy use. Ceramic Coated implants have advantages over fully ceramic implants in terms of resistance to fracture and generation of noise. The method of coating is critical to its success.