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    COTSWOLD CLINICS

    Hip Clinic
    Hip Review Clinic
    Hip Revision Surgery

Why do hip replacements wear out?

The forces acting on the hip joint are several multiples of your body weight. Most adults take 3-4 million steps per year and this all contributes to wear over time.

Mechanical load on the hip joint


The friction and wear is primarily at the articulation, were the head moves in the cup. Additionally repeated loading of the joint is transmitted through the implant to the supporting bone.

What is the effect of wear in a hip replacement?

Wear may become apparent by causing local tissue reaction, loosening of the fixation to bone, or mechanical failure of the implant.

During review of hip replacements it is important to consider a wide range of possible "modes of failure", and then act accordingly.


Rim fracture of ceramic bearing

Wear of early teflon plastic cup

Fatigue fracture of uncemented revision stem at 10 years


Modes of failure due to wear in total hip replacement

Cemented Cup
  • Loosening of the bone-cement fixation
  • Failure of the cup-cement fixation
  • Rim impingement
  • Erosion with head penetration
  • Late dislocation due to deformation of the cup
Uncemented Cup
  • Loosening of the bone-implant fixation
  • Failure of the liner locking mechanism
  • Rim impingement
  • Ceramic fracture
  • Erosion with head penetration
  • Late dislocation due to deformation of the cup
Cemented Stem
  • Loosening of the bone-cement fixation
  • Failure of the stem-cement fixation
  • Fatigue fracture
Uncemented Stem
  • Loosening of the bone-implant fixation
  • Stress concentration (thigh pain)
  • Fatigue fracture
Reaction to particulate wear debris


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