The role of polyethylene wear in joint replacement failure

Abstract

Aseptic loosening is the major cause of failure of joint replacement prostheses. Polyethylene implants removed at revision regularly show wear. It is proposed that the polyethylene particles released into the tissues as a consequence of this wear induce a tissue response that precedes aseptic loosening. This paper presents the results of recent invivo and inviro studies of the biological response to polyethylene wear particles undertaken in the authors' laboratories. A clinical perspective is provided by the inclusion of the author's recent observations of retrieval analyses of joint replacement implant wear and the tissue response to polyethylene in humans.