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Wear-through of a modular polyethylene liner: four case reports
C A Engh1, R H Hopper, C A Engh
1Anderson Orthopaedic Research Institute, Alexandria, VA 22307, USA.
Clinical Orthopaedics and Related Research
|February 24, 2001
Summary
Detecting polyethylene wear-through in S-ROM Total Hip System Polydial liners is challenging. Advanced imaging and hip aspiration are crucial for early diagnosis, especially over 10 years post-surgery.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Medical Imaging
Background:
- The S-ROM Total Hip System Polydial polyethylene liner is used in total hip arthroplasties.
- Early detection of polyethylene wear-through is critical to prevent complications and unnecessary acetabular revisions.
Observation:
- Four patients experienced full thickness polyethylene wear-through 11+ years after S-ROM Total Hip System Polydial implantation.
- Radiographic wear measurements (Dorr and Livermore) underestimated actual wear and failed to detect wear-through.
- Excessive femoral head penetration was not radiographically evident with S-ROM components.
Findings:
- Standard radiographic methods were insufficient for diagnosing polyethylene wear-through in these S-ROM cases.
- Higher kilovoltage radiographs improved visualization of the femoral head outline.
- Hip aspiration successfully diagnosed metallosis, indicating significant polyethylene wear.
Implications:
- Additional diagnostic measures beyond standard radiography are necessary for S-ROM Polydial components.
- Yearly follow-up evaluations are essential, particularly for patients 10+ years after S-ROM Polydial surgery.
- Improved diagnostic strategies are needed to manage polyethylene wear in total hip arthroplasty.