Comparison of Steady State Femoral Head Penetration Rates Between Two Highly Cross-Linked Polyethylenes in Total Hip Arthroplasty

Whittaker, John-Paul; Charron, Kory D; McCalden, Richard W.; MacDonald, Steven J.; Bourne, Robert B.

doi:10.1016/j.arth.2009.05.006

Cited by 31 publications

(15 citation statements)

References 52 publications

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“…Five studies were excluded based on clinical assessments of only a bedding-in rate or a steady-state wear rate. 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.…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

“…We identified only one study in which two HXLPE formulations were directly compared using the same followup period and radiographic methodology. Whittaker et al [137] compared radiographic outcomes in two cohorts of patients receiving total hip systems manufactured by Smith & Nephew Inc (Memphis, TN) (n = 47 cases including an XLPE liner) or Zimmer Inc (n = 36 cases including Longevity 1 liners) and with minimum 5-year followup. The authors did not observe a difference in steady-state 2D penetration rates between the XLPE or Longevity 1 cohorts.…”

Section: Systematic Review Of Femoral Head Penetration Studies For Hxmentioning

confidence: 99%

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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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Section: Search Strategy and Criteriamentioning

confidence: 99%

Section: Systematic Review Of Femoral Head Penetration Studies For Hxmentioning

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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“…Ceramic-on-ceramic combinations have been found to squeak and break [25,39] and require optimal placement to avoid the risk of neck-to-socket impingement [41,43]. Metal-on-metal combinations have been associated with pseudotumor formation [2,21] and increased metal ion release, which may lead to cell apoptosis and to DNA changes [22].…”

Section: Introductionmentioning

confidence: 99%

Oxidized Zirconium Head on Crosslinked Polyethylene Liner in Total Hip Arthroplasty: A 7- to 12-year In Vivo Comparative Wear Study

Karidakis

Karachalios

2015

Clinical Orthopaedics &Amp; Related Research

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Background Osteolysis resulting from wear debris production from the bearing surfaces is a major factor limiting long-term survival of hip implants. Oxidized zirconium head on crosslinked polyethylene (XLPE) is a modern bearing coupling. However, midterm in vivo wear data of this coupling are not known. Questions/purposes The purpose of this study was to investigate in vivo whether the combination of an oxidized zirconium femoral head on XLPE produces less wear than a ceramic head on XLPE or a ceramic head on conventional polyethylene (CPE) couplings and whether any of these bearing combinations results in higher hip scores. Methods Between 2003 and 2007, we performed 356 total hip arthroplasties in 288 patients; of those, 199 (69.1%) patients (199 hips) were enrolled in what began as a randomized trial. Unfortunately, after the 57 th patient, the randomization process was halted because of patients' preference for the oxidized zirconium bearing instead of the ceramic after (as they were informed by the consent form), and after that, alternate allocation to the study groups was performed. Hips were allocated into four groups: in Group A, a 28-mm ceramic head on CPE was used; in Group B, a 28-mm ceramic head on XLPE; in Group C, a 28-mm Oxinium head on XLPE; and in Group D, a 32-mm Oxinium head on XLPE. The authors prospectively collected in vivo wear data (linear wear, linear wear rate, volumetric wear, and volumetric wear rate) using PolyWare software. Preoperative and postoperative clinical data, including Harris and Oxford hip scores, were also collected at regular intervals. Of those patients enrolled, 188 (95%) were available for final followup at a minimum of 7 years (mean, 9 years; range, 7-12 years). Results All bearing surfaces showed a varying high bedding-in effect (plastic deformation of the liner) up to the second postoperative year. At 5 years both oxidized zirconium on XLPE groups showed lower (p \ 0.01) volumetric wear (mean ± SD mm 3 ) and volumetric wear rates (mean ± SD mm 3 /year) ( Res (2015) 473:3836-3845 DOI 10.1007 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® (Group C: 356 ± 64 to 215 ± 54 mm 3 /year, Group D: 354 ± 50 to 210 ± 64 mm 3 /year) when compared with ceramic on CPE (Group A: 895 ± 131 to 380 ± 80 mm 3 /year) and ceramic on XLPE (Group B: 1625 ± 253 to 480 ± 101 mm 3 /year) groups. When wear rates of both oxidized zirconium groups were compared, no differences were found at any time interval with the numbers available. Two hips (one from Group A and one from Group B) are scheduled for revision as a result of wear and osteolysis. There were no differences in hip scores among the groups with the numbers available. Conclusions In this study, in vivo wear parameters were lower when the combination of an oxidized zirconium head on XLPE liner was used at an average of 9 years (range, 7-12 years) followup. Further larger-scale clinical studies should confirm these findings and evaluate osteolysis and revision rates...

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“…Highly crosslinked polyethylene was introduced in an effort to decrease wear rates and reduce the risk of osteolysis and aseptic loosening secondary to polyethylene wear. 5,6,9,27,28 Previously, cobaltchrome has been reported to have increased adhesive wear compared with oxidized zirconium on ultra-high molecular weight polyethylene. 17 More recently, cobalt-chrome has demonstrated reduced wear rates using this bearing surface, and highly crosslinked polyethylene has been recommended for younger patients undergoing total hip arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Mid-term survivorship and clinical outcomes of cobalt-chrome and oxidized zirconium on highly crosslinked polyethylene

Petis

Vasarhelyi

Lanting

et al. 2016

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Background:The choice of bearing articulation for total hip arthroplasty in younger patients is amenable to debate. We compared mid-term patient-reported outcomes and survivorship across 2 different bearing articulations in a young patient cohort. Methods:We reviewed patients with cobalt-chrome or oxidized zirconium on highly crosslinked polyethylene who were followed prospectively between 2004 and 2012. Kaplan-Meier analysis was used to determine predicted cumulative survivorship at 5 years with all-cause and aseptic revisions as the outcome. We compared patient-reported outcomes, including the Harris hip score (HHS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Short-form 12 (SF-12) scores.Results: A total of 622 patients were followed during the study period. Mean follow-up was 8.2 (range 2.0-10.6) years for cobalt-chrome and 7.8 (range 2.1-10.7) years for oxidized zirconium. Mean age was 54.9 ± 10.6 years for cobalt-chrome and 54.8 ± 10.7 years for oxidized zirconium. Implant survivorship was 96.0% (95% confidence interval [CI] 94.9%-97.1%) for cobalt-chrome and 98.7% (95% CI 98.0%-99.4%) for oxidized zirconium on highly crosslinked polyethylene for all-cause revisions, and 97.2% (95% CI 96.2%-98.2%) for cobalt-chrome and 99.0% (95% CI 98.4%-99.6%) for oxidized zirconium for aseptic revisions. An age-, sex-and diagnosis-matched comparison of the HHS, WOMAC and SF-12 scores demonstrated no significant changes in clinical outcomes across the groups. Conclusion:Both bearing surface couples demonstrated excellent mid-term survivorship and outcomes in young patient cohorts. Future analyses on wear and costs are warranted to elicit differences between the groups at long-term follow-up.Contexte : Le choix de la surface d'appui à utiliser dans une arthroplastie totale de la hanche chez de jeunes patients ne fait pas l'unanimité. Nous avons comparé les résul-tats déclarés par les patients et la survie à moyen terme associés à 2 surfaces d'appui différentes dans une cohorte de jeunes patients.Méthodes : Nous avons étudié les cas de patients ayant reçu une prothèse de chromecobalt ou de zirconium oxydé couplé au polyéthylène hautement réticulé suivis de façon prospective entre 2004 et 2012. La méthode de Kaplan-Meier a été employée pour déterminer la survie cumulative estimée après 5 ans dans les cas où le résultat est soit la reprise toutes causes confondues, soit la reprise aseptique. Nous avons comparé les résultats déclarés par les patients, notamment au moyen du score de Harris (HHS), de l'indice WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) et des scores issus de la version courte du questionnaire d'évaluation de l'état de santé général SF-12.Résultats : Au total, 622 patients ont été suivis durant la période de l'étude. En moyenne, le suivi a duré 8,2 ans (plage de 2,0 à 10,6 ans) pour le chrome-cobalt et 7,8 ans (plage de 2,1 à 10,7 ans) pour le zirconium oxydé. L'âge moyen des patients était de 54,9 ± 10,6 ans pour le chrome-cobalt et de 54,8 ± 10,7 ans pour...

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Comparison of Steady State Femoral Head Penetration Rates Between Two Highly Cross-Linked Polyethylenes in Total Hip Arthroplasty

Cited by 31 publications

References 52 publications

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

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

Oxidized Zirconium Head on Crosslinked Polyethylene Liner in Total Hip Arthroplasty: A 7- to 12-year In Vivo Comparative Wear Study

Mid-term survivorship and clinical outcomes of cobalt-chrome and oxidized zirconium on highly crosslinked polyethylene

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