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J Arthroplasty. 2013 Jan;28(1):197.e17-21. doi: 10.1016/j.arth.2012.05.014. Epub 2012 Jul 5.

Abrasive wear and metallosis associated with cross-linked polyethylene in total hip arthroplasty.

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Concordia Joint Replacement Group, Concordia Hip & Knee Institute, Winnipeg, MB, Canada.


A 34-year-old female patient received a cobalt-chromium (CoCr) alloy femoral head on cross-linked polyethylene total hip replacement for the revision of her fractured ceramic-on-ceramic total hip replacement. The CoCr alloy femoral head became severely worn due to third-body abrasive wear by ceramic particles that could not be removed by synovectomy or irrigation at revision surgery. Ceramic particles were found embedded in the cross-linked polyethylene liner. The CoCr alloy femoral head exhibited a total mass loss of 14.2 g and the generated wear particles triggered metallosis in the patient. The present case study suggests not revising a fractured ceramic-on-ceramic total hip replacement with a CoCr alloy femoral head and a cross-linked polyethylene liner to avoid metallosis due to third-body abrasive wear.

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