Patterns of failure of ceramic liner in total hip replacement: report of two cases

We report two cases of ceramic liner fracture that occurred 8 months and 12 years after uncemented total hip arthroplasty (one JRI and the other one was Mittelmaier ceramic-on-ceramic prostheses). There was history of fall in one case. The ceramic liner was found within the metal shell in many large pieces and small fragments in one case and with a missing superior sector and titanium shell wear and fracture in the other. Both prostheses were revised with satisfactory outcome. The patterns of the failure of the ceramic liner seem to be acute and multifragmented following a fall and a missing sector of the line following repeated episodes of impingement between the prosthetic neck and the edge of the ceramic liner. This report highlights the fact that there are limitations of ceramic articulation in hip arthroplasty, which both the surgeon and the patient have to be aware of.