Influence of polyethylene and femoral head surface quality on wear: a retrieval study

Thirty-two polyethylene sockets and 22 femoral heads were retrieved because of aseptic loosening more than 9 years after total hip arthroplasty. The volumetric wear rates of the retrieved polyethylene sockets were significantly greater in those coupled with an alumina head (P < 0.05). The retrieved alumina heads showed significantly better surface roughness and roundness than heads of Co-Cr and of stainless steel (P < 0.05). However, no significant difference was found in polyethylene quality demonstrated as fusion defects among the three different groups. The present study suggests that maintaining better surface roughness and roundness of the femoral heads does not always result in an in vivo reduction of polyethylene wear.