Hip Pelvis.  2012 Jun;24(2):148-152. 10.5371/hp.2012.24.2.148.

Bilateral Catastrophic Acetabular Component Failure after Ceramic-on-Polyethylene Total Hip Arthroplasty: A Case Report

• Yoon TR
• Kim HN
• Park KS

• KMID: 1439104
• DOI: http://doi.org/10.5371/hp.2012.24.2.148

Abstract

Ceramic-on-polyethylene components have better wear characteristics than metal-on-polyethylene components in total hip arthroplasty (THA), and thus, extensive wear resulting in penetration of the femoral head through the acetabular cup is rare after ceramic-on-polyethylene THA. However, several reports have been issued regarding catastrophic polyethylene failure in ceramic-on-polyethylene systems. Here, the authors report the first case of bilateral complete polyethylene wear failure with acetabular cup perforation after ceramic-on-polyethylene THA.

Keyword

Polyethylene; Ceramic; Wear; Total hip arthroplasty

MeSH Terms

Arthroplasty
Ceramics
Head
Hip
Polyethylene
Tacrine
Ceramics
Polyethylene
Tacrine

Figure

• 

  Fig. 1 (A) Anteroposterior radiograph of both hips showing superior subluxation of the right femoral head with an obvious bubble sign, indicating severe metallosis. (B) Intraoperative photograph showing many scratches on the alumina femoral head but minimal wear. (C) Intraoperative photograph showing severe PE liner wear and perforation. (D) Intraoperative photograph of the perforated acetabular cup.

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  Fig. 2 (A) Immediate postoperative radiograph of the right revision THA. (B) Immediate postoperative radiograph after implant removal and PROSTALAC insertion. (C) Immediate postoperative radiograph after second stage revision THA. (D) Six-month follow up radiographs showing severe metallosis and the bubble sign on the left THA.

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  Fig. 3 (A) Preoperative radiograph showing aggravated metallosis, acetabular cup perforation, and screw breakage. (B) CT scan showing a right huge buttock mass. (C) Intraoperative photograph showing a dark soft tissue mass in the right gluteal muscle layer. (D) Intraoperative photograph showing many scratches on the alumina femoral head but minimal wear. (E) Intraoperative photograph showing severe wear and perforation of the PE liner. (F) Intraoperative photograph of the perforated acetabular cup.

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  Fig. 4 Radiographs obtained one year after left revision surgery showing good bony ingrowth in the right femoral stem and bony consolidation of the right acetabular cup. The radiographs also show a well-maintained left acetabular cup without osteolysis and two broken screws.

Reference

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