Fourth-Generation Ceramic Head Fracture in Dual Mobility Total Hip Arthroplasty: A Case Report

INTRODUCTION: Rare cases of Biolox® delta ceramic head fractures in ceramic-on-polyethylene bearings have been reported in the literature. Virtually none of these catastrophic injuries have been documented in dual mobility constructs. CASE REPORT: We report a case of fourth-generation delta ceramic head fracture 4.5 years after implantation in a dual mobility total hip replacement constructs as a result of a ground-level fall. The patient underwent revision arthroplasty with another delta ceramic dual mobility construct and was able to return to work in custodial services 2 weeks after the revision procedure. CONCLUSION: In summary, we presented an extremely uncommon case of a fractured fourth generation, Biolox® delta ceramic head in a dual mobility total hip arthroplasty (THA), as a result of a ground-level fall. The patient underwent successful revision surgery to another dual mobility delta ceramic THA. Despite substantial advances in ceramic materials, catastrophic failure of 4th generation ceramic head components can still occur even in dual mobility constructs and require revision arthroplasty surgery.