Catastrophic failure of the acetabular component in a ceramic-polyethylene bearing total hip arthroplasty

Recent research in total hip arthroplasty has focused on attempts to decrease wear at the femoral head-acetabulum articulation, to limit the production of debris that is believed to lead to osteolysis and prosthetic loosening. The use of ceramic-on-polyethylene bearing surfaces has been reported to produce lower wear rates and therefore may increase the life expectancy of the joint arthroplasty. Problems with this bearing have been reported to be due to ceramic femoral head fracture. Reported here are 2 cases of catastrophic failure of total hip arthroplasties, involving a ceramic femoral head, caused by failure of the polyethylene acetabular liner, with subsequent penetration of the femoral head through the acetabular shell.