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

Abstract: Uhra-high-molecular weight polyethylene (UHMWPE) wear, debrisinduced osteolysis is a frequent cause of failure of total hip arthroplasty. Metal-onmetal 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 higher. Osteolysis can deve|op in response to metallic and UHMWPE debris. The following case of massive osteolysis associated with large amounts of cobalt-chrome wear debris shows adhesive and abrasive wear mechanisms, as well as wear caused by third-body cobalt-chrome debris and impingement of the femoral component against the rim of the acetabular cup, which led to failure of a metal-on-metal total hip arthroplasty. Key words: wear, metal, hip, arthroplasty, cobalt-chrome. Polyethylene wear and osteolysis can limit the longevity of total hip arthroplasty (THA). It has been suggested that metal-on-metal articulations may generate less wear and perform more favorably than metal-on-polyethylene articulations Case Report A 76-year-old man complained of left hip pain i4 years after THA with a Sivash metal-on-metal prosthesis (Joint Medical Products, Port Washington, NY) 87