Polyethylene wear and synovitis in total hip arthroplasty: a sonographic study of 48 hips

Forty-six patients (48 hips), operated on with cemented total hip arthroplasty (THA) because of arthrosis, were examined radiographically and sonographically at 10-year follow-up. Polyethylene wear of acetabular cups was measured on conventional non-weight-bearing pelvic radiographs, and the volume of polyethylene debris was calculated. Radiographic signs of loosening were identified. The capsular distance (ie, thickness of the synovium or synovial contents) was measured sonographically. We found a significant correlation between increased volumetric wear and increased capsular distance. Hips with radiographically loose acetabular components had significantly greater volumetric wear and capsular distance than those without signs of acetabular loosening. This relationship was not observed in hips with radiographically loose femoral components. In cemented THA, the volume of polyethylene wear debris and the thickness of the synovium and the synovial contents are related. In the event of radiographic loosening of the acetabular component, they are both increased.