Abstract
Uncemented total hip prostheses were introduced some 40 years ago, after disappointing results with cemented hip prostheses in young and active patients. In orthopedic literature, research on uncemented hip prostheses has focused on the survival of the uncemented femoral stem, and in general, excellent results were reported. Although the femoral component showed excellent performance, recent in vivo studies have reported increased wear of the polyethylene (PE) liner of the uncemented acetabular cup. This PE wear results in PE particles being distributed in the tissue surrounding the prosthesis, with macrophages being activated by these particles. These activated macrophages induce osteolysis (see Fig. 9.1) which in the end results in aseptic loosening of the prosthesis.
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