Radiographic methods for the assessment of polyethylene wear after total hip arthroplasty

All wear-measurement techniques assess femoral head penetration and therefore cannot distinguish between true polyethylene wear and bedding-in. Multiple wear measurements that are made at different time-intervals after bedding-in has occurred are required to determine the true wear rate. Computer-assisted edge-detection techniques offer improved accuracy and precision compared with manual techniques and appear to be ideally suited for the retrospective and prospective examination of large groups of patients with intermediate to long-term radiographic follow-up (more than five years). While radiostereometric analysis offers improved accuracy and precision compared with computer-assisted edge-detection techniques, widescale clinical application is limited because of its relative expense, the required expertise, and the fact that it can only be used in a prospective fashion.