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Impingement and Rim Wear Associated with Early Osteolysis After a Total Hip Replacement A Case Report
Robert L. Barrack, MD; Thomas P. Schmalzried, MD
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Investigation performed at the Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana

Robert L. Barrack, MD
Department of Orthopaedic Surgery, Tulane University School of Medicine, 1430 Tulane Avenue, SL32, New Orleans, LA 70112. E-mail address: rbarrack@tulane.edu

Thomas P. Schmalzried, MD
Joint Replacement Institute at Orthopaedic Hospital, 2400 South Flower Street, Los Angeles, CA 90007

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from the Los Angeles Orthopaedic Foundation. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

J Bone Joint Surg Am, 2002 Jul 01;84(7):1218-1220
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Extract

Periacetabular osteolysis can occur following total hip arthroplasty with cementless acetabular components. Such lytic lesions are generally associated with penetration of the femoral head into the acetabular polyethylene, as seen on standard radiographs 1-3 . The bearing surface between the femoral head and the polyethylene liner is the source of the vast majority of the wear particles, although relative motion between the so-called backside of the polyethylene component and the metal shell can be an additional source of particles 4-6 . We report the case of a patient who had early symptomatic pelvic osteolysis without obvious radiographic linear penetration of the femoral head. In this patient, impingement of the neck of the femoral stem on an elevated rim liner was a major contributing source of polyethylene wear particles.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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