Revision of a total hip arthroplasty due to fracture of a ceramic component is rare. The fracture rate of ceramic components has been reported to be between 0.004%1 and 0.05%2 for femoral heads and between 0.013%2 and 1.1%3 for acetabular liners. Nevertheless, this problem is occurring more frequently because of the increasing use of ceramic total hip replacements. Revision arthroplasty performed because of a fractured ceramic component carries a high risk of failure: the fragments of the failed component are sharp and harder than metal; if left in the articular space, these fragments would act as an abrasive paste, and the use of a metal head against a polyethylene liner in the revision arthroplasty would quickly lead to catastrophic wear and failure of these new total hip implants4-6 (Fig. 1). Thus, revision arthroplasty performed because of a fractured ceramic component is difficult and the failure rate has been reported to be as high as 31%6. Fig. 1 Early failure of a revision arthroplasty performed because of fracture of a ceramic femoral head. The aims of the present study were to evaluate the outcome of revision total hip arthroplasty performed specifically to treat fracture of a ceramic component, to identify technical factors affecting the outcome, to propose some tips and tricks to make the process of revising a total hip arthroplasty for this reason easier, and to suggest guidelines for the treatment of a ceramic component fracture. From 1990 to 2009, 8022 primary ceramic hip prostheses were implanted at our institute; 3275 (40.8%) were in men and 4747 (59.2%) were in women. Additional patient demographic information is given in Table I. Kaplan-Meier curves with revision for ceramic fracture as the end point were computed to evaluate the rate of ceramic fracture. The analysis …