Polyethylene failure is a rare complication of ceramic-on-polyethylene total hip arthroplasty due to characteristics of ceramic. Complications associated with ceramic-on-polyethylene articulations have been studied extensively, however, only few reports have described its catastrophic wear and concurrent pseudotumor formation. The etiology of this biological reaction and concurrency of pseudotumor formation with metallosis remain unclear. We report two cases of wear of the acetabular liner in a ceramic-on-polyethylene prosthesis due to total hip arthroplasty (THA) long time ago. They came back to the clinic with the history of worsening hip pain and abnormal radiological and clinical findings. Then they underwent surgery and metallosis and pseudotumors were detected and revisions were performed for them. It is necessary to evaluate patients underwent THA complaining of hip pain for component wear and be checked the cup appear well fixing and fairly oriented on follow-up radiographies. Close follow ups can prevent accelerated polyethylene wear in ceramic-on-polyethylene coupling THA.
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