Hip Pelvis.  2019 Jun;31(2):124-127. 10.5371/hp.2019.31.2.124.

Non-traumatic Ceramic Head Fracture in Total Hip Arthroplasty with Ceramic-on-Ceramic Articulation at Postoperative 16th Years

• Kocadal O
• Ozler T
• Bolukbasi
• Altintas F

• KMID: 2448032
• DOI: http://doi.org/10.5371/hp.2019.31.2.124

Abstract

Ceramic articulation has gained popularity in total hip arthroplasty (THA); however, one of the most important concerns about the use of ceramic materials is the potential for breakage. Importantly, almost all ceramic fractures occur within the first six years after surgery. Here, we present a case report of a 52-year-old female patient who experienced an atraumatic ceramic head fracture at the 16th year after surgery. Key parameters that may be associated with ceramic head fracture are considered to be the use of a 28-mm head and high body mass index (BMI); the patient described here had a BMI of 34.3 kg/m2. Surgical treatment of the case included removal of the broken ceramic head and replacement with an alumina matrix composite ceramic head. At the 12th month follow-up visit, the patient was mobilized independently and could perform her daily activities. Ceramic head fracture after THA may occur even in late periods after surgery. For the treatment of fractures of ceramic material, the fractured component must be removed together with extensive soft tissue excision to ensure that no residual fragments are left behind.

Keyword

Ceramics; Arthroplasty; Hip; Hip prosthesis

MeSH Terms

Aluminum Oxide
Arthroplasty
Arthroplasty, Replacement, Hip*
Body Mass Index
Ceramics*
Female
Follow-Up Studies
Head*
Hip
Hip Prosthesis
Humans
Middle Aged
Aluminum Oxide

Figure

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  Fig. 1 Pelvic anteroposterior radiography reveals the non-centralized position of the ceramic head in the acetabulum on the right side.

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  Fig. 2 Computed tomographic evaluation reveals fragmentation in the ceramic head (A). Acetabular cup anteversion was measured as 14° (B).

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  Fig. 3 Intraoperative image of the broken ceramic head.

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