Surveillance of Arc2f polyethylene after 15 years of implantation

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Background:To investigate the behavior of Arc2f polyethylene (PE) component after a minimum of 15 years post implantation and its possible reasons for failure.Methods:Between January 1988 and March 1995, 557 cementless total hip arthroplasties were performed in 578 patients. A total of 435 patients (450 hips) were followed up for 18.6 years (range 15–22).Results:At 10 years follow-up no cup needed revision surgery. After 15 years of implantation, we observed massive PE wear in 140 cups (31%) with large osteolytic lesions. A revision procedure was performed in all cases. Exchange only of the PE liner was sufficient in 78 cases, whilst in 59 the cup was also revised. PE insert thickness and the type of prosthetic head were found to be related to PE wear.Conclusions:We postulate that the massive failure seen is attributed to the manufacturing of the PE insert. We advocate following all patients that have an implant lasting a decade after implantation for routine monitoring to identify those at risk for accelerated PE wear.

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