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The fracture rate of third-generation ceramic liners is greatly reduced compared with first- and second-generation liners because of improvement in the design and manufacturing process. The ABC (alumina-bearing couple) ceramic liner is one such design, and fracture of this type of liner has not been reported. We report three cases of fracture of an ABC ceramic liner occurring within 3 years of implantation. The liner was broken into multiple pieces in two patients, whereas in one patient it was broken only in its periphery. These patients were treated with débridement and cementation of the metal-inlay polyethylene liner into the retained acetabular shell.
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Diwanji et al. (2007) studied this question.
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