We report a complication during total hip arthroplasty using an uncemented press-fit acetabular shell and ceramic liner for a woman with osteoarthritis. Fracture of the ceramic liner occurred during its insertion owing to non-concentric reduction. The main body of the ceramic liner became wedged in the acetabular shell and was resistant to removal. The shell itself was immovable owing to the prior insertion of 2 polyaxial screws, to which access was covered. Successful removal involved drilling a hole in the ceramic liner as a stress riser, and then cracking the liner with a Steinman pin.
MeskoJW. Acute liner disassociation of a Pinnacle acetabular component. J Arthroplasty2009;24:815–8.
2.
HowcroftDHeadMSteeleN. Bearing surfaces in the young patient: Out with the old and in with the new?Curr Orthop2008;22:177–84.
3.
HamiltonWGMcAuleyJPDennisDAMurphyJABlumenfeldTJPolitiJ. THA with Delta ceramic on ceramic: Results of a multicenter investigational device exemption trial. Clin Orthop Relat Res2010;468:358–66.
4.
MeskoJWD'AntonioJACapelloWNBierbaumBENaughtonM. Ceramic-on-ceramic hip outcome at a 5- to 10-year interval: Has it lived up to its expectations?J Arthroplasty2011;26:172–7.
5.
MurphySBEckerTMTannastM. Two- to 9-year clinical results of alumina ceramic-on-ceramic THA. Clin Orthop Relat Res2006;453:97–102.
6.
Garcia-CimbreloEGarcia-ReyEMurcia-MazonABlanco-PozoAMartiE. Alumina-on-alumina in THA: A multicenter prospective study. Clin Orthop Relat Res2008;466:309–16.
7.
SarialiEStewartTMamoudyPJinZFisherJ. Undetected fracture of an alumina ceramic on ceramic hip prosthesis. J Arthroplasty2010;25:658.e1–5.
8.
CapelloWND'AntonioJAFeinbergJRManleyMTNaughtonM. Ceramic-on-ceramic total hip arthroplasty: Update. J Arthroplasty2008;23(7 Suppl):39–43.
9.
HannoucheDZaouiAZadeganFSedelLNizardR. Thirty years of experience with alumina-on-alumina bearings in total hip arthroplasty. Int Orthop2011;35:207–13.
10.
McCarthyMJHalawaM. Lining up the liner: 2 case reports of early ceramic liner fragmentation. J Arthroplasty2007;22:1217–22.
11.
MinBWSongKSKangCHBaeKCWonYYLeeKY. Delayed fracture of a ceramic insert with modern ceramic total hip replacement. J Arthroplasty2007;22:136–9.
12.
LangdownAJPickardRJHobbsCMClarkeHJDaltonDJGroverML. Incomplete seating of the liner with the Trident acetabular system: A cause for concern?J Bone Joint Surg Br2007;89:291–5.
13.
SquireMGriffinWLMasonJBPeindiRDOdumS. Acetabular component deformation with press-fit fixation. J Arthroplasty2006;21(6Suppl 2):72–7.
14.
SchleicherIHaasHAdamsTSSzalayGKleinHKordelleJ. Minimal-invasive posterior approach for total hip arthroplasty versus standard lateral approach. Acta Orthop Belg2011;77:480–7.
15.
PospischillMKranzlAAttwengerBKnahrK. Minimally invasive compared with traditional transgluteal approach for total hip arthroplasty: A comparative gait analysis. J Bone Joint Surg Am2010;92:328–37.
16.
MazoochianFWeberPSchrammSUtzschneiderSFottnerAJanssonV. Minimally invasive total hip arthroplasty: A randomized controlled prospective trial. Arch Orthop Trauma Surg2009;129:1633–9.
