The pumping of fluid in cementless cups with holes

Ten patients who were scheduled for revision for pelvic osteolysis were studied. All had bone-ingrown metal-backed cups with holes and polyethylene liners. Pressures were measured in the osteolytic lesion and in the hip joint while applying cyclic forces across the artificial joint. In 4 cases with lesions that were fully contained by bone, loading of the hip produced a pressure wave in the osteolytic lesion. Cyclic forces, such as those that occur in normal gait, can act on the polyethylene liner, the metal shell, and the supporting bone to pump fluid in the retroacetabular osteolytic lesion. This pumping action may contribute to the pathogenesis of osteolysis by the mechanisms of fluid pressure, fluid flow, or the transportation of wear particles.