Factors contributing to the wear of polyethylene in clinical practice

Wear of polyethylene is a major contributor in the failure of total joint replacement. A number of different factors may predispose to increased wear of polyethylene. These can be broadly categorized as (i) material polymorphism, (ii) poor design features and (iii) three-body wear. Many of these factors contribute to the wear encountered in clinical practice. These mechanisms are reviewed and examples identified in which they have resulted in increased wear.