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2014 ; 4
(2
): 51-6
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Catastrophic Failure of the Acetabular Polyethylene Liner in
Ceramic-on-Polyethylene Total Hip Arthroplasty
#MMPMID27298960
Manzano G
; Levin RA
; Mayor MB
; Schwarzkopf R
J Orthop Case Rep
2014[Apr]; 4
(2
): 51-6
PMID27298960
show ga
INTRODUCTION: Catastrophic polyethylene failure is a rare complication of
ceramic-on-polyethylene total hip arthroplasty due to the favorable tribological
characteristics of ceramic. Failure of the polyethylene liner can be disastrous,
increasing periprosthetic osteolysis, metallosis, and risk of dislocation.
Complications associated with ceramic-on-polyethylene articulations have been
studied extensively, however, only few reports have described its catastrophic
wear. We report such a case of complete wear of the acetabular liner in a
ceramic-on-polyethylene prosthesis in a 57-year adult male. CASE REPORT: A
57-year adult male with a history of bilateral total hip arthroplasty presented
to our institution with bilateral hip pain worst on the right. Range of motion
was limited by pain on the right hip at the extremes of motion. Radiographs
revealed severe osteolysis, heterotopic ossification, complete wear of the
acetabular liner, bony impingement of the femoral greater trochanter on the
acetabular rim and superior migration of the femoral head. All findings were
confirmed intraoperatively. Revision of the acetabular components was performed,
which successfully alleviated the patient's symptoms. CONCLUSION: Failure of the
ceramic-on-polyethylene liner in our patient is due to the use of a non-cross
linked polyethylene liner, a highly active lifestyle, and poor follow up.
Arthroplasty surgeons should be aware of this complication especially in highly
active patients with a conventional polyethylene liner and chronic hip pain.