Adverse Soft-Tissue Reaction After Ceramic-On-Ceramic Bearing Fracture Mimicking a Periprosthetic Joint Infection

Prosthetic failure secondary to bearing fracture remains a potential complication in ceramic-on-ceramic total hip arthroplasty. We report the unusual presentation of a ceramic component fracture of a total hip arthroplasty performed 17 years ago that mimicked a periprosthetic joint infection. This case was managed based on the current guidelines and algorithms recommended for periprosthetic joint infection management. Histologic examination of periprosthetic tissue revealed an adverse inflammatory soft-tissue reaction to the ceramic fragments released from the fracture site. Our case highlights a misleading, inflammatory acute response usually associated with an infectious process corresponding to an adverse soft-tissue reaction. High clinical suspicion and a systematic approach are essential to address these deceiving clinical scenarios.