PMC5299559_01
(a). Plain hip x-ray demonstrated multifragment ceramic head failure associated with severe notching of the cone (arrows), (b). intraoperative findings at revision operation showing diffuse metallosis, multifragmented ceramic head, notching of the cone and severe polyethylene insert wear, (c). follow up x-ray at 2 years and (d). final x-ray 13 years after revision operation.
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F1
Radiographs showed a multiple fragmented ceramic head and significant notching of the cone (Fig. 1a). Intraoperatively findings included diffuse metallosis, a pseudocapsule containing black metalloid fluid, excessive wear of the cone, a multifragmented head and major wear of the insert (Fig. 1b). At the 24-month follow-up examination, the patient had no pain, used no walking aids, and had normal activity without any signs of loosening or other implant pathology in plain radiographs (Fig. 1c). An x-ray of her hip 13 years after revision had no signs of wearing or other pathology (Fig. 1d).