Delayed fracture of a ceramic insert with modern ceramic total hip replacement.
We report a case of ceramic liner fracture in a 34-year-old man that occurred 1 year 9 months after total hip arthroplasty with a BiCONTACT (Aesculap, Tuttlingen, Germany) ceramic-on-ceramic prosthesis. The ceramic liner was found within the metal shell in 4 large pieces and multiple small fragments in the peripheral portions. Its condition indicated that the possible mechanism of late ceramic liner chip fracture was repeated episodes of impingement between the prosthetic neck and the edge of the ceramic liner. Squatting, kneeling, and sitting cross-legged caused impingement. These positions are more common in Asian populations than in Western populations. After the joint was thoroughly irrigated, a new modular ceramic liner and a 28-mm ceramic head were implanted.
Min
Byung-Woo
BW
Department of Orthopedic Surgery, School of Medicine, Keimyung University, Daegu, South Korea.
Song
Kwang-Soon
KS
Kang
Chul-Hyung
CH
Bae
Ki-Cheol
KC
Won
Ye-Yeon
YY
Lee
Kwon-Yong
KY
D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D002516:Ceramics; D003646:Debridement / Q000379:methods; D019544:Equipment Failure Analysis; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation / Q000379:methods