Clinical Orthopaedics and Related Research®

, Volume 469, Issue 12, pp 3415–3422 | Cite as

Polyethylene Wear is Related to Patient-specific Contact Stress in THA

  • Robert Košak
  • Veronika Kralj-Iglič
  • Aleš Iglič
  • Matej Daniel
Basic Research



General numerical models of polyethylene wear and THA simulators suggest contact stresses influence wear. These models do not account for some patient-specific factors. Whether the relationship between patient-specific contact stress and wear apply in vivo is unclear.


We therefore determined whether (1) contact stress distribution at the prosthesis-cup interface and (2) hip geometry and cup inclination are related to wear in vivo.


We retrospectively reviewed the radiographs of 80 patients who had aseptic loosening of their THAs as determined by radiographic criteria. We determined linear penetration and volumetric wear using postoperative and last followup radiographs. Contact stress distribution was determined by the HIPSTRESS method. The biomechanical model was scaled to fit the patient’s musculoskeletal geometry of the pelvis, trochanteric position, and cup inclination using the standard postoperative radiograph.


Linear penetration and volumetric wear correlated with peak contact stress. Polyethylene wear was greater in THAs with a medial position of the greater trochanter and smaller inclination of the acetabular cup.


Our observations suggest wear is specific to contact stresses in vivo.

Clinical Relevance

Long-term wear in a THA can be estimated using contact stress analysis based on analysis of the postoperative AP radiograph.


Femoral Head Contact Stress UHMWPE Polyethylene Wear Volumetric Wear 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Jan Sýkora and Vane Antolič for valuable discussions and help in gathering the data. We thank to Anthony Byrne and Douglas R. Pedersen for help in preparation of the manuscript.


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Copyright information

© The Association of Bone and Joint Surgeons® 2011

Authors and Affiliations

  • Robert Košak
    • 1
  • Veronika Kralj-Iglič
    • 2
  • Aleš Iglič
    • 3
  • Matej Daniel
    • 4
  1. 1.Department of Orthopaedic SurgeryUniversity of Ljubljana Medical CentreLjubljanaSlovenia
  2. 2.Laboratory of Clinical Biophysics, Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
  3. 3.Laboratory of Biophysics, Faculty of Electrical EngineeringUniversity of LjubljanaLjubljanaSlovenia
  4. 4.Laboratory of Biomechanics, Department of Mechanics, Biomechanics and Mechatronics, Faculty of Mechanical EngineeringCzech Technical University in PraguePrague 6Czech Republic

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