An In Vitro Model for Fluid Pressurization of Screw Holes in Metal-Backed Total Joint Components

Kurtz, Steven M.; Harrigan, Timothy P.; Herr, M.; Manley, Michael

doi:10.1016/j.arth.2004.11.003

Cited by 10 publications

(5 citation statements)

References 16 publications

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“…This is supported by our findings in spite of slight inconsistencies at the acetabular site which may be partially due to the different pathogenesis of retroacetabular and femoral osteolysis 1,28 . Furthermore, the classification scheme of acetabular lesions used in our study might be less sensitive than at the femoral site.…”

Section: Discussionsupporting

confidence: 79%

Influence of Demographic, Surgical and Implant Variables on Wear Rate and Osteolysis in Abg I Hip Arthroplasty

Gallo¹,

Havranek²,

Cechová³

et al. 2006

BIOMED PAP

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Periprosthetic osteolysis is associated with accelerated wear rates. The goal of this study was to investigate the influence of demographic and technical variables on wear rates and size of osteolytic lesions. Eighty retrieved ABG I prostheses were analyzed according to prospectively established criteria. There were 22 men and 58 women with an average age of 52 years (34-65) at the time of revision. The average time from index surgery to revision was 67 months (26 to 106). Polyethylene wear measurements were performed using a Universal-type measuring microscope. The average linear wear and volumetric wear rate was 0.363 mm per year (0-0.939, SD 0.241) and 161 mm 3 per year (0-467, SD 118.2), respectively. The wear rates were significantly higher (a) in patients with primary osteoarthritis in comparison with postdysplastic hips, (b) in hips where zirconia prosthetic heads articulated against the polyethylene liner, and (c) in cups placed laterally to Kohler's line. Risk that linear wear rate could be more than 0.2 mm per year was three times higher in patients who were operated in 1997 and later (OR 3.0, 95 % CI 1.126-7.993, p = 0.03). A strong association was revealed between magnitude of wear and size of femoral osteolysis.

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Section: Discussionsupporting

confidence: 79%

Influence of Demographic, Surgical and Implant Variables on Wear Rate and Osteolysis in Abg I Hip Arthroplasty

Gallo¹,

Havranek²,

Cechová³

et al. 2006

BIOMED PAP

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“…The pressure alone may induce osteolysis, more likely it may transport particles to the retroacetabular space [34]. Many implant related variables have been implicated in this process including metal finish, liner thickness and component gap with in vitro studies showing pressure fluctuations can be minimised by tight conformity of implants [35]. Whilst this remains a consideration, it is not one our study was designed to address.…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Polyethylene Wear and Periprosthetic Osteolysis in Total Hip Arthroplasty at 12 Years in a Randomized Controlled Trial Cohort

Broomfield

Malak

Thomas

et al. 2017

The Journal of Arthroplasty

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Background Polyethylene acetabular components are commonplace in hip arthroplasty. Highly cross-linked polyethylene (HXLPE) has lower wear than ultra-high molecular weight polyethylene (UHMWPE). Evidence suggests wear particles induce inflammation causing peri-prosthetic osteolysis contributing to implant loosening with wear rates of 0.05mm/yr considered safe. We aimed to compare incidence and volume of peri-acetabular osteolysis between HXLPE and UHMWPE using computed tomography (CT). Methods Initially 54 hips in 53 patients were randomized to HXLPE or UHMWPE acetabular liner. At 10 years 39 hips in 38 patients remained for radiostereometric analysis (RSA) demonstrating significantly lower wear in the HXLPE group. At 12 years 14 hips in 13 patients were lost to follow-up leaving 25 hips for CT assessment. Images were reconstructed to detect osteolysis and where identified, areas were segmented and volumised. Results Osteolysis was observed in eight patients, seven from the UHMWPE group and only one from the HXLPE group (Fisher's Exact p=0.042). There was no correlation between amount of polyethylene wear and osteolysis volume however, RSA measured wear rate in patients with osteolysis from both groups was significantly higher than overall average wear rate. Conclusion This data demonstrates lower incidence of peri-acetabular osteolysis in the HXLPE group of a small cohort. Whilst numbers are too low to estimate causation, in the context of lower wear in the HXLPE group this finding supports the hypothesis that HXLPE may not elevate osteolysis risk and hence does not suggest HXLPE wear particles are more biologically active than those generated by earlier generations of polyethylene.

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“…Moreover, when sterilised by gamma irradiation in the air, the PE can undergo significant deterioration of their mechanical and chemical properties after long-term in vivo function [46]. In addition, the multi-hole design of the cup, together with a poor locking mechanism for the PE liners in the ABG I cups, could lead to the repetitive generation of screw-hole fluid pressure at levels greatly exceeding the threshold for OL induction [47]. These characteristics and the fact that only patients with failed implants were included could bias our results by providing an inadequate number of hips with lower wear rates and/or less severe osteolysis.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for accelerated polyethylene wear and osteolysis in ABG I total hip arthroplasty

Gallo

Havranek

Zapletalová

2009

International Orthopaedics (SICOT)

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We analysed data from 155 revisions of identical cementless hip prostheses to determine the influence of patient-, implant-and surgery-related factors on the polyethylene wear rate and size of periprosthetic osteolysis (OL). This was calculated by logistic regression analysis. Factors associated with an increased/decreased wear rate included position of the cup relative to Kohler's line, increase in abduction angle of the cup, traumatic and inflammatory arthritis as a primary diagnosis, and patient height. Severe acetabular bone defects were predicted by an increased wear rate (odds ratio, OR=5.782 for wear rate above 200 mm 3 /y), and increased height of the patient (OR= 0.905 per each centimetre). Predictors of severe bone defects in the femur were the increased wear rate (OR=3.479 for wear rate above 200 mm 3 /y) and placement of the cup outside of the true acetabulum (OR=3.292). Variables related to surgical technique were the most predictive of polyethylene wear rate.

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An In Vitro Model for Fluid Pressurization of Screw Holes in Metal-Backed Total Joint Components

Cited by 10 publications

References 16 publications

Influence of Demographic, Surgical and Implant Variables on Wear Rate and Osteolysis in Abg I Hip Arthroplasty

Influence of Demographic, Surgical and Implant Variables on Wear Rate and Osteolysis in Abg I Hip Arthroplasty

The Relationship Between Polyethylene Wear and Periprosthetic Osteolysis in Total Hip Arthroplasty at 12 Years in a Randomized Controlled Trial Cohort

Risk factors for accelerated polyethylene wear and osteolysis in ABG I total hip arthroplasty

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