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In our case study, we examine a case of catastrophic failure of a total hip arthroplasty acetabular component leading to complete central wear by the ceramic femoral head, requiring revision total hip arthroplasty. Despite subtle clinical findings, initial orthopaedic evaluation and treatment yielded a diagnosis of total hip arthroplasty dislocation. While a much more common phenomenon, the diagnosis led to futile initial attempts at closed reduction. Our index of suspicion must remain high to pick up on subtle, less common diagnoses we will encounter.