Management of polyethylene wear associated with a well-fixed modular cementless shell during revision total hip arthroplasty.

We identified 128 revision total hip arthroplasties from 1993 to 2005 involving a well-fixed Harris-Galante Porous (HGP)-I or HGP-II acetabular component with minimum 2-year post-revision follow-up. Three treatment cohorts were identified. Of the hips that underwent modular liner exchange at revision, 14 hips (25%) required re-revision of the acetabular component, 8 for liner dislodgement, 3 for osteolysis and poly-wear, 2 for dislocation, and 1 for aseptic loosening. Of the hips that underwent revision of the well-fixed shell, 4 (15%) required subsequent re-revision of the acetabular component; 2 for dislocation and 2 for aseptic loosening. Six hips (27%) in the cemented liner group were re-revised; 4 for dislocation and 2 for loosening. Complete revision of a well-fixed HGP acetabular component is more reliable than liner exchange or liner cementation.