Prosthetic Loosening in Total Hip Replacements
Total replacement of arthritic joints with artificial metal and plastic materials has provided dramatic relief of pain and improvement in function for millions of patients with end-stage arthritis.1 It has also revolutionized the surgical treatment of arthritis for the past 30 years. Despite the enormous success of these procedures, however, aseptic loosening of the components—often associated with periprosthetic osteolysis and frequently necessitating revision surgery—remains the major problem. The THAs done in the 1970s had loosening rates of 30% to 40% by 10 years after surgery.2,3 Improvements in surgical techniques, prosthetic designs, and biomaterials1,4–6 have subsequently improved the longevity of the prosthesis, with only 3% of the femoral components and 10 percent of the acetabular components of THAs now requiring revision surgery at 10 to 15 years.7 Even though these results appear satisfactory for the vast majority of the elderly patients, continuously increasing life expectancy of the population in developed countries and demands for making these procedures available for younger, heavier, and more active patients necessitate continued investigation to extend the longevity of these procedures even further.
KeywordsFatigue Titanium Arthritis Osteoporosis Polyethylene
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