The Journal of Hip Surgery 2017; 01(02): 118-120
DOI: 10.1055/s-0037-1603628
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Atraumatic Delta Head Fracture in a Ceramic-On-Polyethylene Total Hip Arthroplasty

Sameer R. Oak
1   Cleveland Clinic, Orthopaedic and Rheumatologic Institute, Cleveland, Ohio
,
Salvatore J. Frangiamore
1   Cleveland Clinic, Orthopaedic and Rheumatologic Institute, Cleveland, Ohio
,
Carlos A. Higuera Rueda
1   Cleveland Clinic, Orthopaedic and Rheumatologic Institute, Cleveland, Ohio
,
Alison Klika
1   Cleveland Clinic, Orthopaedic and Rheumatologic Institute, Cleveland, Ohio
,
Robert Molloy
1   Cleveland Clinic, Orthopaedic and Rheumatologic Institute, Cleveland, Ohio
› Author Affiliations
Further Information

Publication History

27 January 2017

24 April 2017

Publication Date:
02 June 2017 (online)

Abstract

A 47-year-old man underwent a left ceramic-on-polyethylene total hip arthroplasty with a delta ceramic femoral head. At 20 months postoperatively, he presented with acute left groin pain after he stepped over a fishing rod while on a boat. A fracture of the femoral head without trauma was diagnosed upon presentation. Manufacturing practices with improvements in each successive generation have decreased historically high ceramic fracture rates considerably. Although femoral head fractures have proven to be extremely rare both in ceramic-on-polyethylene articulations and with the newest delta femoral head, it is important to remain vigilant in all situations involving ceramics.

 
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