Does Neck/Liner Impingement Increase Wear of Ultrahigh-Molecular-Weight Polyethylene Liners?

We explore the hypothesis that repetitive impingement increases wear of ultrahigh-molecular-weight polyethylene inserts. During revision total hip arthroplasty, 113 acetabular components were retrieved and examined for impingement, backside wear, and articular wear. Sixty percent of acetabular liners showed evidence of prosthetic impingement, with moderate or severe damage to the rim in 32%. Moderate or severe backside damage was present in 31%. Backside wear was found in 61% (22/36) of liners exhibiting impingement vs 16% (12/73) of liners without impingement (P < .0001). The average articular wear rate of liners with moderate/severe impingement damage was 159 ± 42 mm3/y, compared with 70 ± 21 mm3/y for liners with no/mild impingement damage (P = .02). Repetitive impingement frequently occurs after total hip arthroplasty and leads to a multitude of adverse events, including motion between the liner and the acetabular shell.