title: Resurfacing hip arthroplasty. Classification of loosening and the role of prosthesis wear particles.
abstract: Operative grading of loosening and histologic examination of the periprosthetic tissues and the femoral and acetabular bone-cement interfaces were undertaken in 72 revised resurfacing hip arthroplasties. By correlating the degree of macroscopic and microscopic loosening at the bone-cement interface, a classification of the stages of loosening at the bone-cement interface was devised. Examination of the femoral bone-cement interface of solidly fixed prosthesis components has demonstrated the presence of polyethylene wear particles and a macrophage response at the interface prior to loosening. This suggests that wear particles may migrate along bone-cement interfaces that are both macroscopically and microscopically solid, and emphasizes the important role of wear particles in prosthesis loosening.
authors.affiliation: Department of Orthopaedic Surgery and Trauma, Royal Adelaide Hospital, Australia.
authors.forename: D W
authors.initials: DW
authors.lastname: Howie
authors.forename: B L
authors.initials: BL
authors.lastname: Cornish
authors.forename: B
authors.initials: B
authors.lastname: Vernon-Roberts
mesh_terms: D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D002965:Classification; D003239:Connective Tissue Cells; D006622:Hip Prosthesis; D006801:Humans; D008859:Microscopy, Polarization; D008875:Middle Aged; D011095:Polyethylenes / Q000032:analysis; D011475:Prosthesis Failure; D012086:Reoperation
chemical_list: D011095:Polyethylenes