Early failure for wear after ceramic-on-highly cross-linked polyethylene total hip arthroplasty: a case report

Abstract

Background Highly cross-linked polyethylene (HXLPE) enhances the anti-wear characteristics of the conventional polyethylene (PE). Early failure for wear after ceramic-on-highly cross-linked polyethylene (CoHXLPE) total hip arthroplasty (THA) is extremely rare. Case presentation We described the case of a 60-year-old man who underwent right CoHXLPE THA because of the developmental dysplasia hip (DDH) complained pain 32 months after this procedure. Plain radiographs showed that eccentric wear existed at the polyethylene insert. However, the patient refused surgery at that time and did not stop weight-bearing. The right hip pain continued for 7 months. Plain radiographs of the pelvis showed that the HXLPE liner was penetrated and partial inner wall of acetabular shell was worn. Acetabular cup revision was performed, and the ceramic head and HXLPE were exchanged. Conclusions Difficult reduction during primary THA, especially for DDH, can result in higher abductor tension, which may lead to early eccentric wear of the prosthesis. Whenever eccentric wear of HXLPE liner was found, weight-bearing must be stopped to avoid the accelerated wear and adverse reactions to metal debris (ARMD).

Effect of Operation Room Nursing Intervention and Ceramic Prosthesis on Total Hip Arthroplasty

“…Synderm and others synthesized relevant guidelines and literature and found that if corresponding preventive measures were not taken after hip arthroplasty, DVT confirmed by venography occurred in 30% [ 3 ]. Li and Zhang also showed that the incidence of DVT after hip arthroplasty was 20% without preventive measures [ 4 ]. According to Triantafyllou et al, the probability of DVT after joint replacement is 45% [ 5 ].…”