Impingement and Rim Wear Associated with Early Osteolysis After a Total Hip Replacement

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 radiographs1-3. 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 particles4-6. 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.