Radiographic methods of wear analysis in total hip arthroplasty

Polyethylene wear is an important factor in failure of total hip arthroplasty (THA). With increasing numbers of THAs being performed worldwide, particularly in younger patients, the burden of failure and revision arthroplasty is increasing, as well, along with associated costs and workload. Various radiographic methods of measuring polyethylene wear have been developed to assist in deciding when to monitor patients more closely and when to consider revision surgery. Radiographic methods that have been developed to measure polyethylene wear include manual and computer-assisted plain radiography, two- and three-dimensional techniques, and radiostereometric analysis. Some of these methods are important in both clinical and research settings. CT has the potential to provide additional information on component orientation and enables assessment of periprosthetic osteolysis, which is an important consequence of polyethylene wear.