Early fracture of a plasma cup ceramic liner: a case report and surface analysis

Background: Ceramic surfaces offer excellent tribological properties and for this reason are frequently used in younger patients with osteoarthritis of the hip. However, they may fracture easily owing to low tolerance to tensile and impact stresses in particular. We report a case of early fracture of a currently available ceramic liner in a 44-year-old woman with revision total hip arthroplasty. Methods and Results: Scanning electron microscopy and macroscopic fractographic examination were done to elucidate the cause of failure. These showed the fracture started most probably at the inner surface of the cup. Several mechanisms of fracture initiation are discussed in the paper. Conclusion: This is the first report on early fracture of the Plasma cup ceramic liner in white man. The fracture occurred intraoperatively or early postoperatively while the diagnosis was determined much later despite the patient had experienced sensations of subluxations long time before.