The spine journal : official journal of the North American Spine Society
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Polyethylene (PE) has been used in total disc replacements (TDRs) in Europe since the 1980s. However, the extent of surface damage of PE, including rim fracture and wear, after long-term implantation remains poorly understood. ⋯ This is the first study to quantitatively analyze the long-term PE damage mechanisms in contemporary TDRs. The TDRs displayed surface damage observed previously in both hip and knee replacements. Because of the evidence of increasing wear with implantation time, along with the demonstrated potential for osteolysis in the spine, regular long-term follow-up for patients undergoing TDRs is warranted.