Metallosis in Sequelae of Prosthetic Revision for Ceramic Components Fracture: A Case Report with Clinical Presentation Mimicking Periprosthetic Hip Infection

Ceramic on ceramic total hip arthroplasties have been developed and widely used during last decades because of their long-term survival and biomechanical properties. One of the most dangerous complication of these implants is the fracture of the ceramic components. The management of this condition should be carefully planned and the choice of the new implant is crucial. We describe a rare case of severe hip synovitis due to massive metallosis in sequelae of mismanaged prosthetic revision for fracture of the ceramic acetabular liner with an unusual clinical presentation that simulate a periprosthetic infection.

Unusual Case of Acetabular Liner Dissociation Following Failure of Ceramic-OnCeramic Bearing Total Hip Arthroplasty: A Case Report

Modular hip implants can improve construct stability and the rate of volumetric wear in Total Hip Arthroplasty (THA), however, there is still a 0.2-10% risk of dislocation. We report the unusual case of a 54-year-old lady who presented with a dislocated migrated ceramic liner following a twisting injury. She had undergone a ceramic-on-ceramic THA five years earlier. This diagnosis of the dislocated liner was confirmed with computed tomography (CT) scanning. Review of National Joint Registry data showed ceramic-on-ceramic acetabular liner dissociation to be rarer than in those with metal-on-polyethylene (incidence 0.27 vs. 0.46 per 1000 prosthesis years). We suggest the liner may have migrated in retrograde along the iliopsoas. We recommend the use of cross-sectional imaging (CT) to assist in confirming the diagnosis and planning future surgery.