Wear and periprosthetic osteolysis: the problem.

The dominant long-term problem in total hip replacement surgery, and an important problem in total knee replacement surgery, is wear of the polyethylene and its resulting periprosthetic osteolysis. Several of the key features of this unique disease are presented focusing on the importance of periprosthetic osteolysis, comprehension of the general progressive nature of periprosthetic osteolysis, understanding of the diverse radiographic evidence of this disease, and the consequences that can occur from the disease.