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.