We present a 48-year-old woman who had a failed previous ceramic-on- ceramic total hip arthroplasty performed for early coxartrosis secondary to acetabular dysplasia. She had fracture and protrusion of the ceramic liner through the titanium acetabular shell without any apparent trauma, possibly due to mistakes during the implantation of the ceramic liner into the metal shell at the initial operation. She was revised with allograft, reinforcement ring, all-polyethylene cup and reinforced stainless-steel femoral head. We think that a layer of polyethylene may be used for elimination of liner impingement with screw heads and for stress absorption, particularly at the time of head implantation.

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