Prosthetic liner wear in total hip replacement: a longitudinal 13-year study with computed tomography

Area of Science:

• Orthopedic surgery
• Medical imaging
• Biomedical engineering

Background:

• Total hip replacement (THR) is a common procedure for hip osteoarthritis.
• Long-term monitoring of THR components is crucial for detecting wear and loosening.
• Osteolysis is a significant complication following hip arthroplasty.

Observation:

• A 45-year-old woman underwent THR in 1992.
• Six serial computed tomography (CT) examinations were performed over 13 years.
• Femoral head penetration into the cup increased from 2.6 mm in 2004 to 5.0 mm in 2017.

Findings:

• Serial CT imaging guided revision surgery to liner replacement only, avoiding full prosthesis removal.
• CT data ruled out osteolysis, which was confirmed during surgery.
• The extracted liner exhibited 5.5 mm of wear at its thinnest point.
• CT revealed a change in liner wear direction from cranial to dorsal.

Implications:

• Modern CT techniques can detect early signs of hip prosthesis wear and complications.
• Non-invasive CT monitoring allows for timely, less invasive revision procedures.
• Accurate assessment of wear progression and direction can optimize implant management and patient outcomes.