Abstract
The enduring success of the low-friction arthroplasty, advanced by Sir John Charnley as a solution for hip arthrosis, may be appreciated by the fact that in 2002 almost 700000 primary and revision hip and knee arthroplasties were performed in the United States, a number more than doubling on a global basis (Table 2.1). The prevalence of aseptic loosening attributed to ultra-high molecular weight polyethylene (UHMWPE) wear debris-induced osteolysis is in the single digits in most contemporary knee series, with some reports describing prosthesis survival beyond 20 years. Despite this obvious success, UHMWPE wear is an inescapable consequence of total joint articulation and is of contemporary concern particularly as our population grays and lifestyle demands increase. Appreciating both the causes and remedies of in vivo UHMWPE failure assists the goal of avoiding total knee arthroplasty revision as an endpoint.
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