title: Delayed fracture of a ceramic insert with modern ceramic total hip replacement.
abstract: 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.
authors.affiliation: Department of Orthopedic Surgery, School of Medicine, Keimyung University, Daegu, South Korea.
authors.forename: Byung-Woo
authors.initials: BW
authors.lastname: Min
authors.forename: Kwang-Soon
authors.initials: KS
authors.lastname: Song
authors.forename: Chul-Hyung
authors.initials: CH
authors.lastname: Kang
authors.forename: Ki-Cheol
authors.initials: KC
authors.lastname: Bae
authors.forename: Ye-Yeon
authors.initials: YY
authors.lastname: Won
authors.forename: Kwon-Yong
authors.initials: KY
authors.lastname: Lee
mesh_terms: 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