How safe are ceramic heads as hip endoprostheses? A series of three head fractures within 3 months.

A report is given of a series of three ceramic head fractures involving articulation with polyethylene cups. No sure cause for the marked increase in occurrence could be found, as the heads were not from the same manufacturing lot, nor was there evidence of a material defect or an error in the implantation technique. Head fractures in the combination ceramic-polyethylene are reported very rarely because of the very low statistical probability. For this reason the present authors are continuing to use ceramic heads, but wish, in the interests of "informed consent," to draw attention to the risk of head fractures.