Late dissociation of an alumina-on-alumina bearing modular acetabular component

Alumina-on-alumina bearings for total hip arthroplasty have been introduced as a promising alternative to reduce wear debris and to increase the life expectancy of the prosthesis. We report a case of a late dissociation of an alumina-on-alumina bearing modular acetabular component, which occurred 2 years, 8 months after surgery. Detailed analysis of the retrieved prosthesis suggested that the cause of the failure may be strong rotational torque developed by a roughening of the bearing's alumina surface caused by edge loading (microseparation). The strong friction torque in articulation may explain the higher reported rate of mechanical loosening of the acetabular component in alumina-on-alumina bearing total hip prostheses.