Modeling polyethylene wear acceleration due to femoral head dislocation damage

Scratching, scraping, and metal transfer to femoral heads commonly accompany acetabular shell contact during dislocation and closed reduction maneuvers. While head damage conceptually leads to accelerated wear, reports on this subject are mainly anecdotal, and differ widely on the potency of such effect. Towards better understanding this relationship, a physically validated finite element (FE) model was used to compute polyethylene wear acceleration propensity of specific head damage patterns on thirteen retrievals. These FE models estimated wear increases averaging half an order of magnitude when compared to simulations for undamaged heads. There was no correlation between the number of dislocations sustained and wear acceleration. These results underscore the importance of implant-gentle closed reduction, and heightened wear monitoring of successfully reduced dislocation patients.