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The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report
Published on: August 4, 2022
Catastrophic failure of a modular revision total hip polyethylene insert
James Bowen Stiehl1, Mohammed R Mahfouz
1Department of Orthopedic Surgery, Medical College of Wisconsin, Columbia St Mary's Hospital, Milwaukee, Wisconsin, USA.
The Journal of Arthroplasty
|January 2, 2007
Summary
Early failure of polyethylene components after hip revision surgery can occur. This case highlights subtle factors like liner thickness and patient activity that may contribute to such failures.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Medical Device Failure Analysis
Background:
- Modular polyethylene components are used in total hip arthroplasty.
- Early catastrophic failure of these components can occur, particularly after revision surgery.
- Understanding failure mechanisms is crucial for improving implant longevity.
Observation:
- A case of polyethylene liner failure within 18 months of revision total hip arthroplasty is presented.
- No obvious technical or mechanical failure cause was initially identified.
- The polyethylene insert underwent gas plasma sterilization with a 4-month shelf life.
Findings:
- Radiographic analysis revealed 2.8 mm of cup penetration prior to revision.
- The polyethylene liner was catastrophically destroyed at the time of revision surgery.
- Potential contributing factors included a thin liner, increased hip separation, femoral head mismatch, and high patient activity.
Implications:
- This case underscores the need to investigate subtle factors influencing polyethylene liner durability.
- Further research into the interplay of implant design, sterilization, and patient-specific factors is warranted.
- Improved understanding may lead to enhanced implant designs and patient selection protocols to prevent early failures.
