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Case Reports
. 2024 Feb 21;58(4):447-455.
doi: 10.1007/s43465-024-01108-4. eCollection 2024 Apr.

A Very Rare Form of Ceramic Head Fracture in Bipolar Hemiarthroplasty and Total Hip Arthroplasty: Unique Experience and Literature Review

Joo-Hyoun Song  1 , Young Wook Lim  2 , Se-Won Lee  3 , Hyun Woo Park  1 , Howon Jeong  1 , Seungbae Oh  1   4
Affiliations
Case Reports

A Very Rare Form of Ceramic Head Fracture in Bipolar Hemiarthroplasty and Total Hip Arthroplasty: Unique Experience and Literature Review

Joo-Hyoun Song et al. Indian J Orthop. .

Abstract

Introduction: A fracture of the ceramic head in bipolar hemiarthroplasty using an inner polyliner has not been reported yet, and there seems to be no report of simultaneous breakage of the fourth-generation BIOLOX Delta ceramic head and liner in total hip arthroplasty.

Method: A 44-year-old male patient underwent bipolar hemiarthroplasty using a third-generation BIOLOX Forte ceramic head 3 years and 9 months earlier for osteonecrosis of femoral head (ONFH) and visited our hospital due to a ceramic head fracture. Conversion total hip arthroplasty was performed. A 64-year-old female patient underwent total hip arthroplasty using a fourth-generation BIOLOX Delta ceramic head and liner articulation for osteoarthritis of the hip. The ceramic head and liner were fractured during the third dislocation. Ceramic head and liner exchange revision surgery was performed.

Conclusion: When using ceramic bearings, fractures or delamination following trauma can occur, confirming the need to carefully evaluate the condition of the ceramic components in symptomatic patients.

Keywords: Arthroplasty; Ceramics; Hemiarthroplasty; Hip; Replacement.

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Conflict of interest statement

Conflict of InterestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Early stage of osteonecrosis of femoral head (ONFH)
Fig. 2
Fig. 2
Bilateral bipolar hemiarthroplasties for early stage of osteonecrosis of femoral head
Fig. 3
Fig. 3
Radiographs and computed tomography (CT) of the pelvis and hip showing a fracture of the ceramic head
Fig. 4
Fig. 4
Ceramic head fracture in bipolar hemiarthroplasty
Fig. 5
Fig. 5
Postoperative radiograph showing conversion total hip arthroplasty
Fig. 6
Fig. 6
Right total hip arthroplasty for primary hip arthritis
Fig. 7
Fig. 7
Staged bilateral total hip arthroplasties for primary hip arthritis
Fig. 8
Fig. 8
Right hip radiographs and computed tomography (CT) taken in emergency room showing comminuted ceramic femoral head and liner fracture
Fig. 9
Fig. 9
Clinical photographs of ceramic head and liner fracture after explant
Fig. 10
Fig. 10
Postoperative radiograph showing revision total hip arthroplasty and well-maintained implant
See this image and copyright information in PMC

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