Damage of an Alumina-on-Alumina Bearing Surface from a Difficult Reduction of a Total Hip Arthroplasty

The most common cause of long-term failure of a total hip arthroplasty is aseptic loosening1. Wear debris, in particular polyethylene debris, is primarily responsible for the biological reaction that leads to bone resorption and loosening of the implants2-5. This, combined with the improvement in the toughness of alumina, has evoked a resurgence in the use of alumina-on-alumina bearing surfaces, where less friction and wear occur6. Contemporary alumina-on-alumina total hip systems incorporate a surface-treated metal-backed alumina socket to overcome the high rate of cup loosening associated with the original component designs without metal backing. Both the short-term and the medium-term results associated with these systems are encouraging7,8.