The procedural standard for the fixation of metallic acetabular shells is under-reaming and impaction. Recently, concerns have arisen regarding achieving and maintaining secure ceramic liners when thin shells are deformed during normal insertion. Failure to achieve an adequate ceramic taper lock has been associated with clinical disassembly and liner fracture. Additionally, this phenomenon has been hypothesized as a possible cause of articular “squeaking”, leading to revision in a small number of patients. This study evaluates the influence of shell deformation on the locking mechanism integrity of contemporary modular acetabular designs employing ceramic liners.

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