Polyethylene wear from femoral bipolar neck-cup impingement as a cause of femoral prosthetic loosening.
A 33-year-old woman underwent an uncemented bipolar hip arthroplasty for osteoarthrosis of the left hip in 1985. Because of painful aseptic loosening, the bipolar implant was revised to a total hip prosthesis in 1994. Membranous tissues around the implant histologically presented foreign-body reaction against polyethylene debris. The retrieved implant showed polyethylene wear of the rim of the bipolar cup. Three-dimensional measurement of the surface configuration of the polyethylene of the cup indicated that wear debris had been generated almost exclusively from femoral bipolar neck-cup impingement. Volumetric wear in the articulating dome portion of the polyethylene was negligible. This report clearly illustrates how impingement of a bipolar cup on the femoral neck can be a major source of polyethylene wear debris which induces femoral osteolysis and subsequent stem loosening.
Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
S
S
Kobayashi
K
K
Takaoka
A
A
Tsukada
M
M
Ueno
D000328:Adult; D005260:Female; D006621:Hip Joint / Q000503:physiopathology; D006622:Hip Prosthesis; D006801:Humans; D010003:Osteoarthritis / Q000601:surgery; D011095:Polyethylenes; D011474:Prosthesis Design / Q000009:adverse effects; D011475:Prosthesis Failure; D016059:Range of Motion, Articular; D012086:Reoperation; D013499:Surface Properties; D016896:Treatment Outcome
D011095:Polyethylenes