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has been cited by the following article:

• TITLE: A late dissociation of the ceramic component of a sandwich liner cup in a total hip arthroplasty—Case report and review of the literature

  AUTHORS: Pieter-Jan De Roo, Franky Steenbrugge, Martijn Raaijmaakers

  KEYWORDS: Total Hip Arthroplasty; Sandwich Cup; Complication; Hip Instability; Cup Revision

  JOURNAL NAME: Case Reports in Clinical Medicine, Vol.2 No.2, May 24, 2013

  ABSTRACT: We present a case of a 71-year-old woman with unexplained instability of her total hip arthroplasty 12 years after implantation due to loosening of the ceramic component of a sandwich ceramic in polyethylene liner. She experienced in total 2 dislocations in 6 months. These events occurred without fracture of the ceramic liner. Sandwich ceramic liners were introduced with the idea of combining the benefits of ceramic and polyethylene bearings in total hip arthroplasty in order to reduce wear and to allow a ceramic on ceramic bearing to be used in a cup designed for polyethylene inserts only. Although some reports showed promising early results, case reports and later on retrospective analysis showed high fracture rates of the ceramic liner component. We believe that loosening of the ceramic component may precede fracture of the liner and that a ceramic on ceramic configuration is preferable.