Failure of a metal-on-metal total hip arthroplasty from progressive osteolysis

Ultra-high-molecular weight polyethylene (UHMWPE) wear, debris induced oste olysis is a frequent cause of failure of total hip arthroplasty. Metal-on-m etal total hip arthroplasty eliminates the generation of UHMWPE particulate debris. Although the volumetric wear of a metal-on-metal articulation may be lower than a metal-UHMWPE articulation, the number of particles may be h igher. Osteolysis can develop in response to metallic and UHMWPE debris. Th e following case of massive osteolysis associated with large amounts of cob alt-chrome wear debris shows adhesive and abrasive wear mechanisms, as well as wear caused by third-body cobalt-chrome debris and impingement of the f emoral component against the rim of the acetabular cup, which led to failur e of a metal-on-metal total hip arthroplasty.