To the Editor,

I appreciate the response of Drs. Bonilla and Bautista to our study, and their comments are well taken. The DePuy Pinnacle (Warsaw, IN, USA) acetabular cup and liner construct does indeed have an excellent track record as they noted. However, the complication of liner dissociation is alarming. Since raising awareness in this article, our group has been alerted to anecdotal reports of 12 other liner failures. We hope this will be an ongoing discussion that can be addressed by surgeons and the implant manufacturer.