Wear-induced osteolysis and synovial swelling in a patient with a metal-polyethylene wrist prosthesis.

We present a patient with a metal and polyethylene wrist prosthesis who had recurrent synovial swelling on the volar side of the wrist. Surgical exploration showed synovitis, a severely worn and broken polyethylene insert, polyethylene wear particles, and titanium debris from fretting corrosion. Pathological analysis showed macrophage-phagocytosing polyethylene wear particles and titanium oxide debris. This shows that polyethylene and titanium wear in wrist prosthesis might be a bigger problem than originally believed.