A ceramic surfaced oxidized Zr femoral component was used in total knee replacedent. Prior mechanical testing had shown a decrease in adhesive and abrasive wear using this material as compared with CoCrMo suggesting its use in younger patients in whom long-term PE wear is a consideration. The alloy had no demonstrable Ni impurities and was applicable to patients with Ni or Co allergies. In a randomized prospective study comparing femoral components of the same design but fabricated either of cast CoCrMo or oxidized Zr, there was a more rapid return of flexion and regaining functional milestones in the oxidized Zr group. No adverse effects had been observed at the 2-year evaluation.