Osteolysis due to particle wear debris following total hip arthroplasty: the role of high-density polyethylene.

It seems likely that the osteolysis seen in total hip arthroplasty, and commonly attributed to wear debris, is actually caused by changes of volume and pressure in the cavity housing the implant. Improvements in cementing technique reduce the incidence of osteolysis. There is no evidence to suggest that this osteolysis is a biological response to wear debris or that the process is different on the femoral and the acetabular side. Similar changes can be seen on both sides of an arthritic hip joint that has not been subjected to surgery.