THE ROLE OF POLYETHYLENE WEAR IN JOINT REPLACEMENT FAILURE

Aseptic loosening is the major cause of failure of joint replacement p rostheses. Polyethylene implants removed at revision surgery regularly show wear. It is proposed that the polyethylene particles released in to the tissues as a consequence of this wear induce a tissue response that precedes aseptic loosening. This paper presents the results of re cent in vivo and in vitro studies of the biological response to polyet hylene wear particles undertaken in the authors' laboratories. A clini cal perspective is provided by the inclusion of the authors' recent ob servations of retrieval analyses of joint replacement implant wear and the tissue response to polyethylene in humans.