Wear of a highly cross-linked polyethylene liner associated with metallic deposition on a ceramic femoral head

A 68-year-old patient underwent revision surgery for recurrent dislocation of a ceramic-on-polyethylene uncemented hip arthroplasty implanted 6 months previously. The aluminum oxide femoral head was found to have titanium deposition measuring 5 by 10 mm in an area articulating with the highly cross-linked polyethylene liner. The liner was observed to possess severe scratching produced by articulation with the titanium deposited on the ceramic head. Despite improved scratch resistance of ceramic-bearing surfaces, irregularities introduced by metallic deposition after recurrent dislocation can damage a highly cross-linked polyethylene liner.