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This case report describes a 72-year-old female presenting with pain and squeaking 11 years after ceramic-on-ceramic THA, where radiographs revealed femoral head eccentricity. Implant analysis following single-component revision arthroplasty demonstrated abnormal wear and deformation of both the femoral head and acetabular liner without fracture. The authors hypothesize a third-body effect from a ceramic fragment detached during initial impaction.
This case highlights a rare complication of ceramic-on-ceramic THA, demonstrating wear and deformation of ceramic components without fracture, likely due to a third-body mechanism.
Introduction: Ceramic-on-ceramic total hip arthroplasty (THA) is recognized for its long-term survivorship, although complications such as squeaking or fractures can occur. We report the first documented case of wear with deformation of a ceramic implant without frank fracture. Case Presentation: A 72-year-old female, implanted 11 years prior, presented with mechanical pain and squeaking. Radiographs revealed femoral head eccentricity. A single-component revision improved the patient’s symptoms. Implant analysis demonstrated abnormal wear and deformation of both the femoral head and the acetabular liner, without fracture. Discussion: The most likely hypothesis is a third-body effect, secondary to a ceramic fragment detached during initial impaction. This case highlights the importance of a meticulous surgical technique and consideration of individual biomechanics when implanting ceramic-on-ceramic THA.
