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Polyethylene wear and calcar osteolysis
A B Joshi1, L Markovic, T Ilchmann
1Centre For Hip Surgery, Wrightington Hospital, Lancashire, England.
American Journal of Orthopedics (Belle Mead, N.J.)
|February 27, 1999
Summary
Polyethylene wear in total hip arthroplasty correlates with bone loss (osteolysis), particularly in osteoarthritis patients. This suggests wear particles contribute to femoral osteolysis, but the link is weaker in rheumatoid arthritis cases.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Rheumatology
Background:
- Osteolysis, or bone loss, is a significant complication following total hip arthroplasty (THA).
- Polyethylene wear debris is a primary suspected cause of osteolysis, leading to implant loosening.
- Understanding the correlation between wear and osteolysis is crucial for improving THA longevity.
Purpose of the Study:
- To retrospectively examine the correlation between linear polyethylene socket wear and calcar height loss (osteolysis).
- To investigate factors influencing this correlation, including patient diagnosis (osteoarthritis vs. rheumatoid arthritis).
Main Methods:
- Retrospective analysis of 410 THAs in 266 patients with a minimum 10-year follow-up.
- Measurement of linear polyethylene wear and calcar height loss.
- Statistical correlation analysis stratified by patient diagnosis.
Main Results:
- A significant positive correlation was found between polyethylene wear and osteolysis.
- The correlation was stronger in patients with osteoarthritis compared to the general cohort.
- A poor correlation was observed between calcar height loss and wear in patients with rheumatoid arthritis.
Conclusions:
- Femoral osteolysis in THA is strongly associated with the volume of polyethylene wear particles.
- The immune response may play a role, as evidenced by the weaker correlation in rheumatoid arthritis patients, potentially due to immune suppression.
- These findings reinforce the understanding of wear-induced osteolysis mechanisms in THA.