This 2000 narrative review by Ingham and Fisher synthesizes the biological mechanisms linking prosthetic wear debris to late aseptic loosening in total hip replacement, examining UHMWPE, metal-on-metal, and ceramic-on-ceramic bearing surfaces. The central question: what properties of wear particles — not just how much wear occurs — drive osteolysis?
Understanding that the 0.2-0.8 micron particle size range drives osteolysis helps explain why different bearing surfaces behave differently clinically, even when total wear volumes are similar.
This 2000 narrative review by Ingham and Fisher synthesizes the biological mechanisms linking prosthetic wear debris to late aseptic loosening in total hip replacement, examining UHMWPE, metal-on-metal, and ceramic-on-ceramic bearing surfaces. The central question: what properties of wear particles — not just how much wear occurs — drive osteolysis?
Understanding that the 0.2-0.8 micron particle size range drives osteolysis helps explain why different bearing surfaces behave differently clinically, even when total wear volumes are similar.