{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:38:22Z","timestamp":1787755102027,"version":"build-2784847793"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2019,3,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Polyethylene (PE) liner and femoral head exchange is commonly used to treat periprosthetic osteolysis associated with PE wear after total hip arthroplasty (THA). The purpose of our study was to determine long-term implant survivorship, risk factors for mechanical failure, clinical outcomes, and complications following PE liner and head exchange.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We identified 116 hips in 110 patients treated with PE liner and head exchange from 1993 to 2004. There were 64 women (58%) in the series, the mean age at revision surgery was 58 years, and the mean follow-up was 11 years (range, 2 to 23 years). Radiographic review determined the location and size of osteolytic defects before the revision surgery. Implant survivorship was determined using Kaplan-Meier survival analysis. Cox regression analysis was used to determine factors that were predictive of failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Implant survivorship free of repeat revision for any cause was 91% (95% confidence interval [CI] = 86% to 96%) at 5 years, 81% (95% CI = 74% to 90%) at 10 years, and 69% (95% CI = 55% to 84%) at 15 years. Reasons for repeat revision included aseptic acetabular loosening in 5 hips (4%) and subsequent wear of conventional PE with osteolysis in 5 hips (4%). No patient who underwent revision with highly cross-linked PE subsequently had a repeat revision due to wear. The absolute risk of acetabular component loosening was 23% for patients with osteolysis in 3 zones, 40% for those with osteolysis involving more than half the cup circumference, and 21% for those with osteolytic defects of &gt;600 mm\n                      <jats:sup>2<\/jats:sup>\n                      . The mean Harris hip score improved from 77 before the PE liner and head exchange to 87 after it (p &lt; 0.001). The most common complication was dislocation, which occurred in 19 hips (16%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>PE liner and head exchange provides acceptable long-term implant survivorship with good clinical outcomes. Complications are not uncommon, and steps should be taken to mitigate hip instability. Acetabular revision may be considered when in situ components have a poor track record or are malpositioned, or when preoperative radiographs demonstrate large osteolytic defects threatening cup fixation. Use of highly cross-linked PE at revision was protective against subsequent PE wear and osteolysis, although this did not reach significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.18.00522","type":"journal-article","created":{"date-parts":[[2019,3,7]],"date-time":"2019-03-07T14:52:36Z","timestamp":1551970356000},"page":"421-428","source":"Crossref","is-referenced-by-count":33,"title":["Polyethylene Liner and Femoral Head Exchange in Total Hip Arthroplasty"],"prefix":"10.2106","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7390-3169","authenticated-orcid":false,"given":"Stephen M.","family":"Petis","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2730-5344","authenticated-orcid":false,"given":"Bernd","family":"Kubista","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Medical University Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1323-7213","authenticated-orcid":false,"given":"Robert U.","family":"Hartzler","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2398-1724","authenticated-orcid":false,"given":"Matthew P.","family":"Abdel","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1422-0306","authenticated-orcid":false,"given":"Daniel J.","family":"Berry","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,3,6]]},"reference":[{"issue":"7","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.arth.2008.06.008","article-title":"Bearings of the future for total hip arthroplasty","volume":"23","author":"Manley","year":"2008","journal-title":"J Arthroplasty."},{"issue":"12","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.2106\/JBJS.L.01177","article-title":"Revision total hip arthroplasty with retained acetabular component","volume":"96","author":"Adelani","year":"2014","journal-title":"J Bone Joint Surg Am."},{"issue":"4","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.arth.2004.02.001","article-title":"Isolated liner exchange in revision total hip arthroplasty: clinical results using the direct lateral surgical approach","volume":"19","author":"O\u2019Brien","year":"2004","journal-title":"J Arthroplasty."},{"key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/01.blo.0000194091.10447.79","article-title":"Isolated liner exchange using the anterolateral approach is associated with a low risk of dislocation","volume":"441","author":"Smith","year":"2005","journal-title":"Clin Orthop Relat Res."},{"issue":"4","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/j.arth.2004.02.005","article-title":"Isolated acetabular polyethylene exchange through the anterolateral approach","volume":"19","author":"Wade","year":"2004","journal-title":"J Arthroplasty."},{"issue":"5","key":"bib6-20230810","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1302\/0301-620X.89B5.18623","article-title":"Isolated acetabular liner exchange compared with complete acetabular component revision in revision of primary uncemented acetabular components: a study of 1649 revisions from the Norwegian Arthroplasty Register","volume":"89","author":"Lie","year":"2007","journal-title":"J Bone Joint Surg Br."},{"issue":"12","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1302\/0301-620X.87B12.16349","article-title":"Revision of an acetabular liner has a high risk of dislocation","volume":"87","author":"Blom","year":"2005","journal-title":"J Bone Joint Surg Br."},{"issue":"5","key":"bib8-20230810","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/S0883-5403(03)00266-3","article-title":"Dislocation after polyethylene liner exchange in total hip arthroplasty","volume":"18","author":"Boucher","year":"2003","journal-title":"J Arthroplasty."},{"issue":"4","key":"bib9-20230810","doi-asserted-by":"crossref","first-page":"737","DOI":"10.2106\/00004623-196951040-00012","article-title":"Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. 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Failure"],"short-title":[],"issued":{"date-parts":[[2019,3,6]]},"references-count":23,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.18.00522","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,6]]}}}