Abstract
BackgroundHighly 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 presentationWe 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.ConclusionsDifficult 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).
Highlights
ConclusionsDifficult reduction during primary total hip arthroplasty (THA), especially for developmental dysplasia hip (DDH), can result in higher abductor tension, which may lead to early eccentric wear of the prosthesis
Cross-linked polyethylene (HXLPE) enhances the anti-wear characteristics of the conventional polyethylene (PE)
total hip arthroplasty (THA) is an effective treatment for various end-stage hip diseases, such as osteonecrosis, rheumatoid arthritis, degenerative joint diseases and degenerative diseases caused by developmental dysplasia [1]
Summary
Difficult reduction during primary THA, especially for DDH, can result in higher abductor tension, which may lead to early eccentric wear of the prosthesis.
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