Fourth generation head fracture in ceramic-on-polyethylene bearing after hip revision surgery: a case report

Main Article Content

Roberto Valentini
Andrea Vacchiano
Andrea Sandri
Dario Regis
Carlo Dall’Oca
Bruno Magnan

Keywords

total hip arthroplasty, revision hip surgery, ceramic-on-polyethylene, BIOLOX delta ceramic head, fracture

Abstract

Fourth generation ceramic bearings (BIOLOX delta, CeramTec AG; Phlochingen, Germany) were
developed to reduce wear debris and improve fracture resistance. A case of a fourth generation head fracture
in ceramic-on-polyethylene (COP) coupling after hip revision surgery is reported. A 58-year-old man
was admitted to our department for increasing hip pain following a direct trauma which occurred during
skiing activity 4 months before. Six years earlier, he had undergone a right cementless revision surgery with a
36-mm BIOLOX delta femoral head on polyethylene liner for metallosis and foreign body reaction after primary
total hip replacement for hip osteoarthritis. At admission, radiological evaluation revealed a fracture of
ceramic femoral head requiring a new revision surgery. Extensive synovectomy, lavage and capsulectomy were
performed. Both acetabular cup and femoral stem were well fixed with no damage of trunnion, and therefore
they were retained. A 36-mm internal diameter polyethylene acetabular liner was inserted along a 36-mm
BIOLOX delta head with a BioBall adapter XL. The postoperative course was uncomplicated. At 1-year
follow-up, the patient had a complete functional recovery. To our knowledge, BIOLOX delta ceramic femoral
head fracture after COP hip revision surgery has not been previously reported.

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References

1. Rambani R, Kepecs DM, Mäkinen TJ, Safir OA, Gross AE, Kuzyk PR. Revision total hip arthroplasty for fractured ceramic bearings: a review of best practices for revision cases. J Arthroplasty 2017; 32(6): 1959-64.
2. Huet R, Sakona A, Kurtz SM. Strength and reliability of alumina ceramic femoral heads: review of design, testing, and retrieval analysis. J Mech Behav Biomed Mater 2011; 4(3): 476-83.
3. Tai SM, Parker L, de Roeck NJ, Skinner JA. Recurrent catastrophic ceramic femoral head failure in total hip arthroplasty. Case Rep Orthop 2014; 2014.
4. Heiner AD, Mahoney CR. Fracture of a BIOLOX Delta ceramic femoral head articulating against a polyethylene liner: A case report. JBJS Case Connect 2014; 4(4): e97.
5. Pomeroy E, Rowan F, Masterson E. Atraumatic fracture of a BIOLOX delta ceramic femoral head articulating with a polyethylene liner: A case report. JBJS Case Connect 2015; 5(4): e112.
6. Rankin CS, Robinson PG, Beattie N, Gaston P. Fracture of a BIOLOX delta ceramic femoral head: A case report and update of the literature. JBJS Case Connect 2019; 9(4): e336.
7. Lee GC, Kim RH. Incidence of modern alumina ceramic and alumina matrix composite femoral head failures in nearly 6 million hip implants. J Arthroplasty 2017; 32(2): 546-51.
8. Si HB, Zeng Y, Cao F, Pei FX, Shen B. Is a ceramic-on-ceramic bearing really superior to ceramic-on-polyethylene for primary total hip arthroplasty? A systematic review and meta-analysis of randomised controlled trials. Hip Int 2015; 25(3): 191-8.
9. Trivellin G, Sandri A, Bizzotto N et al. Ceramic liner fatigue fracture: 3-D CT findings in a late recurrent THA dislocation. Orthopedics 2013; 36(1): e101-4.
10. Olmedo-Garcia NI, Zagra L. High risk of complications using metal heads after ceramic fracture in total hip arthroplasty. Hip Int 2019; 29(4): 373-8.

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