The establishment of a polyethylene wear rate threshold for the development of osteolysis at the hip would allow surgeons to identify patients at risk for osteolysis and to implement selective, more frequent follow-up. We reviewed publications that met certain criteria for wear and osteolysis measurement. Based on this review, the incidence of osteolysis increases as the rate of wear increases. The literature indicates that osteolysis rarely is observed at a wear rate of < 0.1 mm/y. We suggest that a practical wear rate threshold of 0.05 mm/y would eliminate osteolysis. This wear threshold suggests that the new cross-linked polyethylenes would reduce osteolysis, provided that in vivo wear rates mirror those observed in vitro. To facilitate future comparison of published data, we suggest that longitudinal wear studies adopt consistent edge detection-based wear measurement techniques and uniform osteolytic lesion classification and measurement schema.

Polls results

On a scale of 1 to 10, rate how much this article will change your clinical practice?

NO change
BIG change
77% Article relates to my practice (14/18)
5% Article does not relate to my practice (1/18)
16% Undecided (3/18)

Will this article lead to more cost-effective healthcare?

94% Yes (17/18)
5% No (1/18)
0% Undecided (0/18)

Was this article biased? (commercial or personal)

0% Yes (0/18)
94% No (17/18)
5% Undecided (1/18)

What level of evidence do you think this article is?

11% Level 1 (2/18)
11% Level 2 (2/18)
61% Level 3 (11/18)
11% Level 4 (2/18)
5% Level 5 (1/18)