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Wear and Osteolysis of Polyethylene Bearings

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Complications after Primary Total Hip Arthroplasty

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Abstract

Osteolysis and aseptic component loosening have been recognized as common mechanisms for late total hip arthroplasty failure. Particulate wear debris from the arthroplasty-bearing surface initiates a process of macrophage-induced, osteoclast-mediated bone resorption around implants. Radiographic patterns of osteolysis differ around cemented and cementless implants based on the patterns of particle access through the effective joint space, and influence the approaches taken during revision surgery. Revision surgery will address the failed bearing surface to decrease the generation of particular debris. The approach to component revision surgery is based on osteolysis lesion size, arthroplasty component stability, locking mechanism integrity, structural bone availability for biologic fixation of revised components, and patient’s health status. This chapter reviews the current knowledge of osteolysis and presents approaches for both conservative and surgical treatment.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Missouri School of Medicine, 1100 Virginia Avenue, Suite 4054, Columbia, MO, 65201, USA

    James A. Keeney MD

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  1. James A. Keeney MD
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Correspondence to James A. Keeney MD .

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Editors and Affiliations

  1. Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA

    Matthew P. Abdel

  2. Division of Adult Reconstruction, Rush University Medical Center, Chicago, Illinois, USA

    Craig J. Della Valle

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Keeney, J.A. (2017). Wear and Osteolysis of Polyethylene Bearings. In: Abdel, M., Della Valle, C. (eds) Complications after Primary Total Hip Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-319-54913-2_13

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  • DOI: https://doi.org/10.1007/978-3-319-54913-2_13

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