{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:42:27Z","timestamp":1777891347185,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["THC"],"published-print":{"date-parts":[[2024,9,3]]},"abstract":"<jats:p>BACKGROUND: Uncemented acetabular components are widely used in modern total hip arthroplasty (THA). Modularity has numerous advantages including the ability to use supplementary screw fixation for the shell, and allow to switch from ceramic to polyethylene (PE) bearings and vice versa, and the use of lipped and face-changing liners. OBJECTIVE: Despite these advantages, a problem with modular PE liners is dissociation. This is a rare complication in modern implants. The rate of liner dissociation is reported to be very low between 0.17% and 0.8%. Typical symptoms are sudden onset of groin pain in a previously well-functioning hip joint, followed by grinding or clicking sensations during hip joint motions indicating, that the femoral head is articulating with the metal acetabular shell rather than with the PE liner. Any newly observed noise or squeaking from a THA should undergo radiographic investigation to exclude liner dissociation. CASE PRESENTATION: We present the case of an 88-yearold male patient who developed PE liner dissociation in a cementless THA with a Pinnacle acetabular component six years after the index operation. We recommended revision of the left hip, which was performed two days later. In the interim, the patient was advised to use a pair of crutches. During revision surgery, it was observed that the metal head made contact with the cementless cup shell without damaging it from a macroscopic standpoint. Consequently, a simple exchange of the PE liner was conducted, and a 36 mm metal head was implanted due to scratches on the original head. CONCLUSION: Early diagnosis facilitates a straightforward exchange of the liner along with the head, potentially preserving the osseous integrated cup shell and stem integrity. Routine radiologic follow-up allows to distinguish between PE liner dissociation and severe PE wear.<\/jats:p>","DOI":"10.3233\/thc-240016","type":"journal-article","created":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T14:15:55Z","timestamp":1719584155000},"page":"3613-3619","source":"Crossref","is-referenced-by-count":0,"title":["Polyethylene liner dissociation in cementless total hip arthroplasty: Ensuring accurate diagnosis"],"prefix":"10.1177","volume":"32","author":[{"given":"Alexander","family":"Schuh","sequence":"first","affiliation":[{"name":"Department of Musculoskeletal Research, Hospital of Trauma Surgery, Marktredwitz Hospital, Marktredwitz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Feyrer","sequence":"additional","affiliation":[{"name":"Department of Industrial Engineering and Health, Institute of Medical Engineering, Technical University of Applied Sciences Amberg-Weiden, Weiden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Achim","family":"Benditz","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Hospital of Trauma Surgery, Marktredwitz Hospital, Marktredwitz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Sesselmann","sequence":"additional","affiliation":[{"name":"Technical University of Applied Sciences W\u00fcrzburg-Schweinfurt, W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Koehl","sequence":"additional","affiliation":[{"name":"Hospital of Trauma Surgery, Marktredwitz Hospital, Marktredwitz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"issue":"6","key":"10.3233\/THC-240016_ref1","doi-asserted-by":"crossref","first-page":"537","DOI":"10.5301\/hipint.5000512","article-title":"The incidence of dissociated liners in 4,751 consecutive total hip arthroplasties using Pinnacle polyethylene acetabular liners","volume":"27","author":"Napier","year":"2017","journal-title":"Hip Int."},{"issue":"3","key":"10.3233\/THC-240016_ref2","doi-asserted-by":"crossref","first-page":"335","DOI":"10.4055\/cios21176","article-title":"Average 22-year results of total hip arthroplasty using harris-galante prosthesis in patients under 50 years","volume":"14","author":"Won","year":"2022","journal-title":"Clin Orthop Surg."},{"issue":"5","key":"10.3233\/THC-240016_ref3","doi-asserted-by":"crossref","first-page":"2747","DOI":"10.1007\/s00402-022-04529-8","article-title":"Dissociation of liner from cup in THA: Does liner damage affect the risk of dissociation","volume":"143","author":"Beckmann","year":"2023","journal-title":"Arch Orthop Trauma Surg."},{"issue":"5","key":"10.3233\/THC-240016_ref4","doi-asserted-by":"publisher","first-page":"e25119","DOI":"10.7759\/cureus.25119","article-title":"Polyethylene liner dissociation in the early post-operative period 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Arthroplasty."},{"key":"10.3233\/THC-240016_ref14","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.CC.22.00348"},{"key":"10.3233\/THC-240016_ref15","first-page":"802753","article-title":"Acetabular liner dissociation following total hip arthroplasty: A rare but serious complication that may be easily misinterpreted in the emergency department","volume":"2015","author":"O\u2019Neill","year":"2015","journal-title":"Case Rep Emerg Med."},{"key":"10.3233\/THC-240016_ref16","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1051\/sicotj\/2019025","article-title":"Acetabular liner dissociation: A case report and review of the literature","volume":"5","author":"Parkar","year":"2019","journal-title":"SICOT J."},{"issue":"1","key":"10.3233\/THC-240016_ref17","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1177\/11207000211008459","article-title":"Dissociation of polyethylene liners with the Depuy Pinnacle cup: A report of 26 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