Polyethylene liner exchange for excessive wear and osteolysis

To determine if polyethylene liner exchange of a total hip arthroplasty decreased wear and slowed the progression of osteolysis, we evaluated 10 hips at a mean 6.2 years after component exchange. Head penetration and lesion size were quantified on serial radiographs using computer-assisted techniques. A mean 7.9 years before component exchange, true polyethylene wear rates averaged 0.36 +/- 0.19 mm/y. A mean 6.2 years after component exchange, average wear rates decreased to 0.17 +/- 0.11 mm/y. Similarly, mean acetabular and mean femoral lesion growth rates decreased. At last follow-up, all components remained radiographically stable. Complications included dislocation (1 patient) and increased wear (2 patients). Modular component exchange with removal of granulomatous tissue has the potential to decrease wear and slow the progression of osteolysis without subsequent component loosening.