Catastrophic acetabular wear following polyethylene liner dissociation with locking-tab damage after total hip arthroplasty: a case report
- 1epartment of Joint Surgery, Affiliated Hospital of Hebei University, Baoding, China
Abstract
BackgroundPolyethylene liner dissociation is an uncommon but potentially severe complication of total hip arthroplasty (THA). Loss of the intended bearing interface can permit direct femoral-head–acetabular-shell articulation, with progressive shell wear, metallic debris deposition, and acetabular bone loss.Case presentationA 73-year-old woman developed left hip pain after an accidental sprain in February 2025, having reported no hip-related symptoms after primary THA in 2020. The index Mindray implants included a 48-mm acetabular shell, a highly cross-linked polyethylene liner, a 28-mm femoral head, and a size-10 stem. Radiographs and CT with three-dimensional volume-rendered reconstruction were used to assess acetabular bone loss, classified as Paprosky type IIA. Revision revealed polyethylene liner dissociation, catastrophic shell wear-through, extensive black metallic debris deposition, and a well-fixed femoral stem. Partial locking-tab damage was identified on gross inspection, but formal retrieval analysis was not performed. Acetabular revision with iliac-crest autografting was performed while retaining the femoral stem. At 6 months, the Harris Hip Score improved from 46 to 82, and radiographs showed a stable acetabular component with evidence of graft incorporation.ConclusionThis case illustrates the potential for clinically occult progression from liner dissociation to catastrophic head-on-shell wear. Gross locking-tab damage did not establish the initiating failure mechanism. Component-preserving acetabular revision was associated with a favorable short-term clinical and radiographic outcome in this patient.
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BibTeX
@article{li2026catastrophic,
title = {{Catastrophic acetabular wear following polyethylene liner dissociation with locking-tab damage after total hip arthroplasty: a case report}},
author = {Weida Li and Zhixing Liang and Zhuangzhuang Dong and Qian Sun and Yu Hou},
journal = {Frontiers in Surgery},
year = {2026},
month = oct,
doi = {10.3389/fsurg.2026.1979979},
url = {https://doi.org/10.3389/fsurg.2026.1979979},
note = {CC BY},
}
RIS
TY - JOUR
TI - Catastrophic acetabular wear following polyethylene liner dissociation with locking-tab damage after total hip arthroplasty: a case report
AU - Weida Li
AU - Zhixing Liang
AU - Zhuangzhuang Dong
AU - Qian Sun
AU - Yu Hou
PY - 2026
DA - 2026/10/23
JO - Frontiers in Surgery
DO - 10.3389/fsurg.2026.1979979
UR - https://doi.org/10.3389/fsurg.2026.1979979
AB - BackgroundPolyethylene liner dissociation is an uncommon but potentially severe complication of total hip arthroplasty (THA). Loss of the intended bearing interface can permit direct femoral-head–acetabular-shell articulation, with progressive shell wear, metallic debris deposition, and acetabular bone loss.Case presentationA 73-year-old woman developed left hip pain after an accidental sprain in February 2025, having reported no hip-related symptoms after primary THA in 2020. The index Mindray implants included a 48-mm acetabular shell, a highly cross-linked polyethylene liner, a 28-mm femoral head, and a size-10 stem. Radiographs and CT with three-dimensional volume-rendered reconstruction were used to assess acetabular bone loss, classified as Paprosky type IIA. Revision revealed polyethylene liner dissociation, catastrophic shell wear-through, extensive black metallic debris deposition, and a well-fixed femoral stem. Partial locking-tab damage was identified on gross inspection, but formal retrieval analysis was not performed. Acetabular revision with iliac-crest autografting was performed while retaining the femoral stem. At 6 months, the Harris Hip Score improved from 46 to 82, and radiographs showed a stable acetabular component with evidence of graft incorporation.ConclusionThis case illustrates the potential for clinically occult progression from liner dissociation to catastrophic head-on-shell wear. Gross locking-tab damage did not establish the initiating failure mechanism. Component-preserving acetabular revision was associated with a favorable short-term clinical and radiographic outcome in this patient.
SN - 2296-875X
ER -