The commonest cause of failure (loosening) of total hip replacement in the long term is:

• A Polyethylene wear debris causing osteolysis and aseptic loosening ✓
• B Cement fracture and fatigue failure
• C Periprosthetic joint infection
• D Recurrent dislocation causing implant migration

Explanation

The leading cause of long-term failure of total hip replacement is aseptic loosening driven by polyethylene wear debris. Ultra-high-molecular-weight polyethylene (UHMWPE) particles (0.1–10 μm) generated at the bearing surface activate macrophages, which release inflammatory cytokines (IL-1, IL-6, TNF-α) stimulating osteoclastic bone resorption — 'particle disease.' This creates periprosthetic osteolytic cysts and eventual implant loosening without infection. Modern cross-linked polyethylene (XLPE) and alternative bearings (ceramic-on-ceramic, metal-on-metal in selected cases) have significantly reduced wear particle generation.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.