A 62-year-old female patient showed radiographic signs of severe linear wear of the acetabular component six years after cementless total hip arthroplasty. This suggested wear-through of the acetabular liner with secondary wear of the titanium shell. At revision surgery wear-through of both the inlay and the acetabular shell were confirmed. Despite meticulous debridement serum titanium levels remained elevated for more than 12 months. Wear-through of a polyethylene acetabular liner with secondary wear of the titanium shell can lead to increased titanium serum levels. Titanium serum levels can remain highly elevated despite revision surgery.
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