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The Journal of Bone and Joint Surgery 81:115-136 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Current Concepts Review

Current Concepts Review - Wear in Total Hip and Knee Replacements*

THOMAS P. SCHMALZRIED, M.D.{dagger}, LOS ANGELES, CALIFORNIA and JOHN J. CALLAGHAN, M.D.{ddagger}, IOWA CITY, IOWA


   Introduction
 
Before the advent of total joint replacement, patients who had end-stage arthritis of the lower extremities had unremitting pain and a greatly decreased functional capacity. In addition, they often were confined to a wheelchair and were dependent on the care of others. Today, the outcomes of primary total hip and knee replacement are predictable and usually excellent35,45,57,64,212,221. Prosthetic joint replacement has dramatically improved the lives of millions of people worldwide.

As the fixation of total joint implants has become more reliable and durable and as the technology of total joint replacement has been applied to younger and more active patients, the current limitations of total joint arthroplasty are related to the wear of the components248. Wear is the removal of material, with the generation of wear particles, that occurs as a result of the relative motion between two opposing surfaces under load. In complex mechanical-biological systems such as . . . [Full Text of this Article]


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