Early morbidity of modular exchange for polyethylene wear and osteolysis

This study assessed the early morbidity associated with modular component exchange surgery for the treatment of accelerated polyethylene wear and osteolysis in 55 patients. Review of the surgical records revealed no significant intraoperative complications, little intraoperative blood loss (mean 333 mL), no allogenic blood transfusions, and no recorded postoperative deep vein thromboses. Eighteen percent of patients, however, experienced postoperative dislocation. Five patients dislocated multiple times, 3 of which required rerevision surgery. Two patients required rerevision for femoral implant fractures related to osteolysis and 1 additional patient required rerevision due to catastrophic failure of the acetabular component 5 years postoperatively. With an average follow-up of 30 months, 6 of the 55 patients treated with modular exchange required rerevision. The results of this study suggest that instability is the most prevalent early complication associated with modular component exchange. As such, we believe that more stable constructs should be emphasized, possibly at the expense of polyethylene thickness.