Surgical management of polyethylene wear and pelvic osteolysis with modular uncemented acetabular components

Osteolysis, usually associated with polyethylene wear, has become one of the most prevalent complications associated with total hip arthroplasty inserted without cement. Management of osteolysis is challenging because the disorder tends to develop silently and surgical intervention can result in complications. In addition, long-term outcomes are unknown. We discuss the current knowledge and data available on polyethylene wear and pelvic osteolysis with modular uncemented acetabular components. We also outline an algorithm for evaluation and treatment of patients. In general, we see patients with well-fixed components every 2 years, and we base follow-up visits after 6 years on predicted polyethylene wear rates and the presence or absence of pelvic osteolysis.