Deformation of the acetabular polyethylene liner and the backside gap

Yamaguchi, M.; Bauer, Thomas W.; Hashimoto, Yasushi

doi:10.1016/s0883-5403(99)90102-x

Cited by 30 publications

(22 citation statements)

References 11 publications

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“…Although the 10.6-year follow-up results are promising and match well with other successful implants, attention must be paid to the fact that holes in the metal shell are pathways for backside generated polyethylene particles. That may lead to osteolysis as suggested by Maloney and Yamaguchi [21,33] and as demonstrated in our radiological examinations. The specific design of this cup with multiple holes placed symmetrically over the entire hemisphere may favor circumferential osteolysis that could lead to microfractures of ingrown bone-bridges.…”

Section: Discussionsupporting

confidence: 79%

“…Many reported series show increasing osteolysis and loosening of cemented and cementless bone ingrowth sockets at mid-to long-term follow-up [2,5,11,15,16,18,21,24,26]. Current problems include modularity [1,5,17], socket-fixation [7,21,30,33], thickness [3,28,31] and backside wear [6] of polyethylene liners as well as size and quality of articulating heads [22]. Because of the high costs of revision surgery, the cup fixation has become a major concern not only for patients and orthopaedic surgeons, but also for third party payers.…”

Section: Introductionmentioning

confidence: 99%

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Cementless hemispheric acetabular component in total hip replacement

Weber¹,

Schaper²,

Pomeroy³

et al. 2000

International Orthopaedics

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A series of 198 total hip arthroplasties was performed using a porous-coated, hemispheric press-fit cup. One hundred and twenty-seven cups were available for clinical and radiological examination at mean followup of 10.6 years. The mean age at the index procedure was 61.2 years. The mean Harris hip score at final follow-up was 89.8. Three cups were revised for aseptic loosening and two liners were changed for eccentric wear and pelvic osteolysis. Nine additional patients showed mild or suspected osteolysis. Two cups were rated "fibrous" stable. There was no correlation between additional screw fixation of the press-fit cup and osteolysis or revision.Résumé Nous avons réalisé une étude rétrospective comprenant 127 prothèses totales de la hanche en utilisant une cupule acetabulaire non cimentée. 'Age moyen des patients lors d'intervention était de 61.2 ans. La durée moyenned' observation post-operatoire était de 10.6 ans. Le score de Harris lors du dernier examen clinique était de 89.9. Trois cupules étaient révisées pour descellement aseptique et deux inserts en polyéthylène étaient changés pour usure et ostéolyse. Neuf autres patients montraient une ostéolyse discrète. Deux cupules étaient stables avec une fixation dite «fibreuse». Aucune corré-lation entre utilisation de vis pour la fixation primaire et le développement d'osteolyse n'a été trouvée.

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Cementless hemispheric acetabular component in total hip replacement

Weber¹,

Schaper²,

Pomeroy³

et al. 2000

International Orthopaedics

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“…Backside wear was implicated in the high rates of retroacetabular osteolysis observed with Hylamer (DePuy DuPont Orthopaedics) liners [39]. Although finite element analysis estimates rates of backside wear to be minimal compared with the articular surface [26], retrieval studies have shown backside volumetric change to occur at only 2.8% of the rate of articular surface wear [23] and that retroacetabular osteolysis does not correlate to backside wear [45]. A further limitation is that the study involved relatively small numbers and that 28% of the cohort was lost to followup or had radiographs that were inadequate and therefore excluded from analyisis; offsetting this, perhaps, is that the loss to followup was distributed equally between the arms (Fig.…”

Section: Discussionmentioning

confidence: 99%

The John Charnley Award: Highly Crosslinked Polyethylene in Total Hip Arthroplasty Decreases Long-term Wear: A Double-blind Randomized Trial

Glyn-Jones

Thomas

Roberts

et al. 2015

Clinical Orthopaedics &Amp; Related Research

131

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Background The use of highly crosslinked polyethylene (HXLPE) is now commonplace for total hip arthroplasty. Hip simulator studies and short-term in vivo measurements suggest that the wear rate of some types of HXLPE is significantly less than conventional ultrahigh-molecularweight polyethylene (UHMWPE). However, there are few long-term data to support its use. Questions/purposes The aim of this study was to measure the long-term steady-state wear of HXLPE compared with UHMWPE liners in a prospective, double-blind, randomized controlled trial using radiostereometric analysis. Methods Fifty-four patients were randomized to receive hip arthroplasties with either UHMWPE liners or HXLPE liners. Complete followup was available on 39 of these patients (72%). All patients received the same cemented stem and an uncemented acetabular component. Threedimensional penetration of the head into the socket was determined at 10 years using a radiostereometric analysis system, which has an in vivo accuracy of \ 0.1 mm. Oxford Hip Scores were compared between the groups. Results At 10 years there was significantly less wear of HXLPE (0.003 mm/year; 95% confidence interval [CI], ± 0.010; SD 0.023; range, À0.057 to 0.074) compared with UHMWPE (0.030 mm/year; 95% CI, ± 0.012; p \ 0.001; SD 0.0.27; range, À0.001 to 0.164). The volumetric penetration from 1 to 10 years for the UHMWPE group was 98 mm 3 (95% CI, ± 46 mm 3 ; SD 102 mm 3

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“…Apart from the articular side, the interface between the liner and metal socket is also a potential source of polyethylene debris in modern modular acetabular implants [1,12,23,25,28,29,36,43,45]. Although articular-sided wear of polyethylene has been well documented and quantified [3,14,20,21,24,42,47], the role of backside wear in modern modular prostheses continues to be controversial because even less is known about backside wear with this newer material [1,12,25].…”

Section: Introductionmentioning

confidence: 99%

“…However, a cause-effect relationship has not been clearly established by these in vitro studies. A few retrieval studies [1,12,23,25,43,45] have also been performed involving direct visual/volumetric assessment of backside wear. However, gaps persist in our knowledge, and there are limited data regarding the in vivo backside wear characteristics of polyethylene liners (especially that of XLPE) and we have a limited understanding of what the important factors are that contribute to backside wear.…”

Section: Introductionmentioning

confidence: 99%

Backside Wear Is Not Dependent on the Acetabular Socket Design in Crosslinked Polyethylene Liners

Bali

McCalden

Naudie

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Although it is understood that backside damage occurs in polyethylene acetabular liners, the effect of highly crosslinked polyethylene, which has completely replaced conventional polyethylene, has yet to be examined. Questions/purposes The purpose of this study was to answer the following questions: (1) With conventional polyethylene (CPE), did the acetabular design make a difference in backside wear? (2) Is there a difference in backside damage between CPE and crosslinked polyethylene (XLPE) liners? (3) With XLPE, is the difference in backside wear between designs still present? (4) Is there any difference in backside damage in various zones on backside of individual liners? Methods This single-institution retrieval analysis involved visual damage scoring on the backside of 233 polyethylene liners implanted between 2002 and 2011. The liners were retrieved from either polished/dovetail cups (PD) or roughened/wire cups (RW) made by two different manufacturers. The inserts were divided into four groups: PD-CPE (n = 105), PD-XLPE (n = 16), RW-CPE (n = 99), and RW-XLPE (n = 13). Aseptic loosening and polyethylene wear were the predominant reasons for revision of CPE liners, whereas instability and infection were the common reasons for revision of XLPE liners. The time in situ (TIS) was shorter for the XLPE liners as compared with the CPE liners (PD-CPE: 8.5 years [SD 4.4]; ; ; ). The backside of each liner was divided into five zones and graded initially from a scale of 0 to 3 for seven different damage modes by one observer. There was substantial interobserver (kappa 0.769) and intraobserver (0.736) reliability on repeat scoring. To compare the effects of crosslinking, a subset of the conventional polyethylene liners was matched to the crosslinked liners based on TIS,

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Deformation of the acetabular polyethylene liner and the backside gap

Cited by 30 publications

References 11 publications

Cementless hemispheric acetabular component in total hip replacement

Cementless hemispheric acetabular component in total hip replacement

The John Charnley Award: Highly Crosslinked Polyethylene in Total Hip Arthroplasty Decreases Long-term Wear: A Double-blind Randomized Trial

Backside Wear Is Not Dependent on the Acetabular Socket Design in Crosslinked Polyethylene Liners

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