A Double-Blind, Prospective, Randomized Controlled Trial Comparing Highly Cross-Linked and Conventional Polyethylene in Primary Total Hip Arthroplasty

Calvert, George T.; Devane, P.; Fielden, Jann; Adams, Kathryn Betts; Horne, J. G.

doi:10.1016/j.arth.2008.02.011

Cited by 66 publications

(56 citation statements)

References 19 publications

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“…Regarding blinding of outcome assessment, six studies [4, 7-9, 15, 23] were adequate and two [5] were unclear. Four studies [5,7,15,23] reported the rate of exclusion were greater than 15℅ and one study [4] did not describe the exact number of participants in both groups.…”

Section: Resultsmentioning

confidence: 99%

“…The randomisation process was described and appropriate for three studies [4,9,23]; the other studies mentioned randomisation allocation but lacked a description of the randomisation method [5,7,8,15]. With respect to allocation concealment, four studies [4,9,15,23] were adequate and four [5,7,8] were unclear. Regarding blinding of outcome assessment, six studies [4, 7-9, 15, 23] were adequate and two [5] were unclear.…”

Section: Resultsmentioning

confidence: 99%

“…1). Four highly cross-linked polyethylene liners were used: Marathon in two studies [4,7], Longevity in two [5,9], Durasul in three [5,8,23], and Crossfire in one [15]. The types of hip implant and fixation method were different among studies.…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of radiological outcomes of highly cross-linked polyethylene versus conventional polyethylene in total hip arthroplasty

Tian

et al. 2009

International Orthopaedics (SICOT)

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The purpose of this study was to summarise the best evidence to assess radiological outcomes of highly crosslinked polyethylene compared with conventional polyethylene in total hip arthroplasty. All randomised, controlled clinical trials comparing highly cross-linked polyethylene with conventional polyethylene were sought and then analysed by two independent reviewers using the Cochrane collaboration guidelines. Eight studies in seven articles were identified as eligible for inclusion. Due to the clinical and methodological heterogeneity, data from the studies included could not be pooled. No failures related to highly cross-linked polyethylene were reported. All highly cross-linked polyethylene groups had a significantly lower wear or penetration than conventional polyethylene groups. This preliminary result suggests that highly cross-linked polyethylene has significantly less wear than conventional polyethylene.Résumé Le but de cette étude est de résumer les données indiscutables dans les prothèses totales de hanche concernant l'évaluation du devenir radiologique du polyéthylène hautement réticulé comparé au polyéthylène conventionnel. Tous les essais contrôlés, randomisés comparant le polyéthylène hautement réticulé au polyéthylène conventionnel ont été analysés par deux reviewers indépendants à partir de la base de Cochrane. 8 études dont 7 articles ont été identifiés et inclus dans ce travail. Du fait de l'hétérogénéicité clinique et méthodologique de ces études, toutes les données n'ont pu être regroupées. Aucun échec du polyéthylène hautement réticulé n'a été rapporté. Dans ces études, tous les groupes concernant le polyéthylène hautement réticulé et ont une usure et une pénétration plus basses que le polyéthylène conventionnel ceci de façon significative. Ces données préliminaires permettent de penser que le polyéthylène hautement réticulé a de façon significative moins d'usure que le polyéthylène conventionnel.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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A systematic review of radiological outcomes of highly cross-linked polyethylene versus conventional polyethylene in total hip arthroplasty

Tian

et al. 2009

International Orthopaedics (SICOT)

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“…We identified one cohort study directly comparing femoral penetration among different HXLPE formulations [137], but this study was excluded from our weighted-averages analysis because it only reported steady-state penetration rates. Similarly, Calvert et al [22] excluded the bedding-in penetration rate and reported only the mean steady-state radiographic penetration rates from 6 months to 4 years. Another study excluded from the weighted-averages analysis was by Fukui et al [45], which did not separate out radiographic outcomes by HXLPE formulation, implying the femoral head penetration behavior was similar between the two groups.…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

History and Systematic Review of Wear and Osteolysis Outcomes for First-generation Highly Crosslinked Polyethylene

Kurtz

Gawel

Patel

2011

Clinical Orthopaedics &Amp; Related Research

407

282

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Background Highly crosslinked polyethylene (HXLPE) was introduced to reduce wear and osteolysis in total joint arthroplasty. While many studies report wear and osteolysis associated with HXLPE, analytical techniques, clinical study design and followup, HXLPE formulation and implant design characteristics, and patient populations differ substantially among investigations, complicating a unified perspective. Questions/purposes Literature on first-generation HXLPE was summarized. We systematically reviewed the radiographic wear data and incidence of osteolysis for HXLPE in hip and knee arthroplasty. Methods PubMed identified 391 studies; 28 met inclusion criteria for a weighted-averages analysis of two-dimensional femoral head penetration rates. To determine the incidence of osteolysis, we estimated a pooled odds ratio using a random-effects model.Results Weighted-averages analyses of femoral head penetration rates in HXLPE liners and conventional UHMWPE liners resulted, respectively, in a mean twodimensional linear penetration rate of 0.042 mm/year based on 28 studies (n = 1503 hips) and 0.137 mm/year based on 18 studies (n = 695 hips). The pooled odds ratio for the risk of osteolysis in HXLPE versus conventional liners was 0.13 (95% confidence interval, 0.06-0.27) among studies with minimum 5-year followup. We identified two clinical studies of HXLPE in TKA, preventing systematic analysis of outcomes. Conclusions HXLPE liner studies consistently report lower femoral head penetration and an 87% lower risk of osteolysis. Reduction in femoral head penetration or osteolysis risk is not established for large-diameter ([ 32 mm) metallic femoral heads or ceramic femoral heads of any size. Few studies document the clinical performance of HXLPE in knees.

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“…At both stages of selection, we estimated chance-adjusted agreement statistics among reviewers with a j statistic (j = 0.917 for abstract review; j = 1.000 for full-text review), and all disagreements were settled by the opinion of a third senior reviewer (GAN-M). Eleven articles [2,4,5,8,14,22,28,33,40,41,49] were deemed eligible through this process and seven studies [9,[16][17][18][19][20][21] were added following a manual search of the bibliographies of the 11 chosen articles for a final study cohort of 18 manuscripts (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

There Are No Differences in Short- to Mid-term Survivorship Among Total Hip-bearing Surface Options: A Network Meta-analysis

Wyles

Jiménez-Almonte

Murad

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Total hip arthroplasty (THA) is increasingly being performed in patients with long life expectancies and active lifestyles. Newer implant bearing surfaces, with superior wear characteristics, often are used in this cohort with the goal of improving longevity of the prosthesis, but comparisons across the numerous available bearing surfaces are limited, so the surgeon and patient may have difficulty deciding which implants to use. Questions/purposes The purpose of this study was to answer the following question: Is there a short-to mid-term survivorship difference between common THA bearings used in patients younger than age 65 years? Methods We conducted a systematic review to identify randomized clinical trials (RCTs) published after 2000 that reported survivorship of ceramic-on-ceramic (CoC), ceramic-on-highly crosslinked polyethylene (CoPxl), or metalon-highly crosslinked polyethylene (MoPxl) bearings. To qualify for our review, RCTs had to have a minimum 2-year followup and study patients were required to have an average age younger than 65 years. Direct-comparison meta-analysis and network meta-analysis were performed to combine direct and indirect evidence. IN, USA). One of the authors certifies that he (RTT), or a member of his immediate family, has received or may receive payments or benefits, during the study period, an amount of less than USD 10,000 from MAKO Surgical Corp, USD 10,000 to USD 100,000 from DePuy Orthopaedics, Inc, and less than USD 10,000 from Wright Medical Technology, Inc. One of the authors certifies that he (RJS), or a member of his immediate family, has received or may receive payments or benefits, during the study period, an amount of USD 10,000 to USD 100,000 from Biomet Inc. 123Clin Orthop Relat Res (2015) 473:2031-2041 DOI 10.1007 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® the three implant types, demonstrating the following probabilities of most effective implant with 95% credible intervals (CrI): CoC = 64.6% (0%-100%); CoPxl = 24.9% (0%-100%); and MoPxl = 9.9% (0%-100%). The CrIs ranged from 0% to 100% for all three bearing surfaces. Direct-comparison meta-analysis allowed for pooling of five RCTs, including 779 THAs, whereas network metaanalysis (before post hoc analysis) enabled pooling of 18 RCTs, including 2599 THAs. Conclusions Current published evidence does not support survivorship differences among commonly used bearing surfaces in patients younger than age 65 years undergoing THA at short-to mid-term followup. Long-term RCT data will be needed to determine if a survivorship benefit is realized in younger, more active patients over time. Level of Evidence Level I, therapeutic study.

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A Double-Blind, Prospective, Randomized Controlled Trial Comparing Highly Cross-Linked and Conventional Polyethylene in Primary Total Hip Arthroplasty

Cited by 66 publications

References 19 publications

A systematic review of radiological outcomes of highly cross-linked polyethylene versus conventional polyethylene in total hip arthroplasty

A systematic review of radiological outcomes of highly cross-linked polyethylene versus conventional polyethylene in total hip arthroplasty

History and Systematic Review of Wear and Osteolysis Outcomes for First-generation Highly Crosslinked Polyethylene

There Are No Differences in Short- to Mid-term Survivorship Among Total Hip-bearing Surface Options: A Network Meta-analysis

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