Alumina-Debris-Induced Osteolysis in Contemporary Alumina-on-Alumina Total Hip Arthroplasty

Aceramic-on-ceramic bearing coupling, because of its qualities of reduced friction and wear, is an attractive alternative bearing surface in total hip arthroplasty. The use of such bearing couplings is likely to reduce problems related to polyethylene wear debris1-6. Osteolysis has only rarely been reported in association with ceramic-on-ceramic bearing couplings, and reports are generally limited to cases involving early generation ceramic bearings or loosened prostheses7,8. Recently, several cases of osteolysis have been reported after total hip arthroplasty with use of a contemporary alumina bearing, but these reports only described the femoral scalloping seen on radiographs and did not present any histological evidence that ceramic particles were the causative factor9. We present the case of a patient who had formation of a large amount of osteolysis about both the acetabulum and the proximal part of the femur, induced by ceramic wear particles from a well-functioning contemporary alumina-on-alumina total hip prosthesis. The patient was informed that data concerning the case would be submitted for publication, and she consented.