We assessed polyethylene wear and osteolysis in 15 patients (30 hips) undergoing staged bilateral total hip arthroplasty, who had a cemented hip arthroplasty on one side and a hybrid arthroplasty on the other. All factors apart from mode of acetabular component fixation were matched. Wear was measured radiographically using Livermore’s technique.

The mean clinical and radiological follow-up was 11.2 years for the cemented arthroplasties and 10.7 years for the hybrid arthroplasties. Mean annual linear wear rate for the cemented cups was 0.09mm/year, and 0.14mm/year for the uncemented cups. This difference was statistically significant (p=0.03), confirming previous reports that polyethylene wear in uncemented cups is greater than in cemented cups. Polyethylene wear in the uncemented cup exceeded wear in the cemented cup by more than > 0.1mm/year in 5 patients, 4 of whom had a BMI of greater than 30.

No periacetabular osteolysis was noted. Femoral osteolysis was present in 5 hybrid arthroplasties and 2 cemented arthroplasties. Zone 7 femoral osteolysis occurred in 3 patients on the side of the hybrid arthroplasty, multifocal femoral osteolysis not involving zone 7 was seen in 2 patients in both hips.

Introduction SLAP (superior labrum anterior and posterior) lesions are a recognised cause of shoulder pain and instability. They can occur following a direct blow, (biceps) traction and compression injuries, and are commonly seen in overhead athletes. Military personnel are physically active and often subjected to trauma. We assessed the incidence of SLAP lesions within a military population presenting with shoulder symptoms.

Methods A retrospective review, of all shoulder arthroscopies performed by a single surgeon between June 2003 and December 2004 at a district general hospital serving both a military and civilian population, was undertaken. The presentation and incidence of SLAP lesions were recorded for both military and civilian patients.

Results 178 arthroscopies were performed on 70 (39.3%) military and 108 (60.7%) civilian patients. The average age was 42.3 (range 17–75), 50 females and 128 males were included. Indications for arthroscopy included pain (75.3%), instability (15.7%), pain and instability (7.9%), or “other symptoms” (1.1%). 39 SLAP lesions (22%) were found and grouped according to the Snyder classification – 20.5% type 1, 69.3% type 2, 5.1% type 3, 5.1% type 4. Patients with a history of trauma or symptoms of instability were more likely to have a SLAP lesion (p< 0.05). The incidence of SLAP lesions in the military patients was 38.6% compared to 11.1% in civilian patients (p< 0.05). After allowing for the increased incidence of trauma and instability in the military, SLAP lesions were still more common in the military patients (p< 0.05).

Conclusions There is a higher than average incidence of SLAP lesions in military patients compared to civilian patients. They tend to present with a history of trauma, as well as symptoms of pain and instability. Given the high incidence in military personnel, this diagnosis should be considered in military patients presenting with shoulder symptoms, and there should be a low threshold for shoulder arthroscopy.