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The Journal of Bone and Joint Surgery 79:1892-3 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

Frantz L. Langlais, M.D., Hervé Thomazeau, M.D., Thomas W. Bauer, M.D., Ph.D., Jiang Ming, M.D., James A. D'Antonio, M.D. and Lawrence G. Morawa, M.D.

TO THE EDITOR:

In "Abrasive Three-Body Wear of Polyethylene Caused by Broken Multifilament Cables of a Total Hip Prosthesis. A Report of Three Cases" (78-A: 1244–1247, Aug. 1996), Bauer et al. reported on osteolysis associated with trochanteric non-union after fixation with cables during total hip replacement. The authors showed that three-body wear of the polyethylene cup (and the femoral head) causing osteolysis originated from intra-articular penetration by macroscopic fragments of cable. However, although large fragments of cable are especially deleterious, we think that trochanteric non-unions can cause osteolysis and loosening even without migration of macroscopic fragments.

Kelley and Johnston1 reported a significant prevalence of loosening of the cup associated with the migration of fragments of not only trochanteric cables but also trochanteric wires toward the acetabular notch, and they hypothesized that the loosening was due to three-body wear of the polyethylene caused by metal debris.

We3 reported on three cases . . . [Full Text of this Article]


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