Reducing the Risk of Ceramic Femoral-Head Fractures

JBJS Case Connector has issued a “Watch” regarding the rare but potentially catastrophic fracture of ceramic femoral heads used in hip replacements.

Ceramic hip components are often chosen for younger patients to minimize long-term wear. Ceramic femoral head fractures arise mainly from trauma; non-compatible, damaged, or contaminated femoral head/stem taper connections; or material or manufacturing defects.

Because ceramic head fractures are more likely to occur from insults during or after implantation than from manufacturing defects, the Watch includes four “golden rules” surgeons can follow to reduce the risk of these events, including making sure that the tapers on both the head and stem are compatible in all dimensions. The Watch also emphasizes the importance of patient education, during which patients should be encouraged to promptly report any and all postsurgical irregularities.

This Watch was prompted by a case report by Pomeroy et al. in the December 23, 2015 JBJS Case Connector, and a report by Heiner and Mahoney in the October 22, 2014 JBJS Case Connector.