Etiology of Osteolysis Around Porous-Coated Cementless Total Hip Arthroplasties

Jasty, Murali; Bragdon, Charles R.; Jiranek, William A.; Chandler, Hugh P.; Maloney, William J.; Harris, William H.

doi:10.1097/00003086-199411000-00018

Cited by 88 publications

(53 citation statements)

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“…Several studies have correlated wear rate with osteolysis [4,13,17,19,36]. It has been suggested that linear wear rates of 0.1 mm/year or less are associated with significantly lower rates of osteolysis than wear rates of more than 0.3 m d y e a r [24].…”

Section: Discussionmentioning

confidence: 99%

“…lntroduction Improvements in implant design and surgical techrlique have reduced the incidence of early failllre of the acetabular and femoral components and ifidreased survivorship of total hip arthroplasty [2,29,31,41]. As a result, osteolysis resulting from ultrahigh molecular weight polyethylene (UHMWPE) wear debris has become one of the most significant factdrs affecting long term survivorship [ 1,13,16,19,49]. Alternative bearing surfaces have been proposed such as ceramic-on-ceramic and metal-on-metal articulations.…”

mentioning

confidence: 99%

“…As a result, osteolysis resulting from ultrahigh molecular weight polyethylene (UHMWPE) wear debris has become one of the most significant factdrs affecting long term survivorship [ 1, 13,16,19,49]. Alternative bearing surfaces have been proposed such as ceramic-on-ceramic and metal-on-metal articulations.…”

mentioning

confidence: 99%

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Polyethylene cross‐linking by two different methods reduces acetabular liner wear in a hip joint wear simulator

D’Lima¹,

Hermida²,

Chen³

et al. 2003

Journal Orthopaedic Research

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Advances in cross-linking have led to the development of wear resistant hltrahigh rnaleeulat. weight pdlyethylenc f@r tdtd joint replacement. This study compared wear reduction by two different croes-lidking methads as measured in a hip bear simulhtdr, On@ highly cross-linked polyethylene was treated with 7.5 Mrad gamma irradiation with post-irradiation annealing add a 'sterilization dose of 2.5 Mrad (10 Gamma), while the other used 9.5 Mrad warm irradiation with 10 MeV electron-beam (9.5 EB). Liners of the same design, made from nominally cross-lhked (gamma sterilized) polyethylene were also tested. Gravimetric wear analysis was performed every 500,000 cycles for 5,000,000 cycles. After correcting for weight gain due to water absorption, the nominally crosslinked liners demonstrated meail wear rates of 15.7 (f1.7) and 12.5 (11.0) mglmillion cycies. Both highly cross-linked polyethylene liners demoiistrated significantly less wear than their respective controls (hith Mean hiear rates of 1.5 (11.2) and -1.4 (11.5) mgl million cycles). The 9.5 EB liners gained weight presumably due to intfea'sed fluid absurptidii, itl addition to tnat measured ih loaded-soaked control implahts. Any wear occurring was therefore assumed td have been more thhn offset by weight gain. Highly cross-linked polyethylene was significantly more wear resistant than non-or ndminally Cro's's-linked polyethylene. The differeilces in wear rates between the two highly crass-linked polyethylene designs (9.5 EB or 10 Ghmma) art2 probably too srriall to be clinically significant. lntroduction Improvements in implant design and surgical techrlique have reduced the incidence of early failllre of the acetabular and femoral components and ifidreased survivorship of total hip arthroplasty [2,29,31,41]. As a result, osteolysis resulting from ultrahigh molecular weight polyethylene (UHMWPE) wear debris has become one of the most significant factdrs affecting long term survivorship [ 1,13,16,19,49]. Alternative bearing surfaces have been proposed such as ceramic-on-ceramic and metal-on-metal articulations. However, these have their own poteritial disadvantages [3,9,18]. The long history and pbpulafitp of UfIMWPE as a bearihg surface has led to research in the development of tougher and fiore wear resistant polpetliylerie rrlatCrialS. These [12]. Another, more resent modification was HylamZr'", L.1 pdlyethylehe irl Which AH 2%-tefided chaili srystallile inorphology *ds ci-&ttPd with thicker lamellae and higher crystallinity thari cdnt.eritiO= iial UHMWPE. The yield strength and ultimate strength were slightly higher, but the elastic modulus was significantly higher than that of cbhventional UHMWPE. High

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Polyethylene cross‐linking by two different methods reduces acetabular liner wear in a hip joint wear simulator

D’Lima¹,

Hermida²,

Chen³

et al. 2003

Journal Orthopaedic Research

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“…The following paragraphs concern only one of the problems such implants have (Bauer and Hirokawa, 1995;Doyle, 1993;Hamilton and Gorczyca, 1995;Jasty et al, 1994).…”

Section: Design and Use Of Load-bearing Implantsmentioning

confidence: 99%

From Wolff's law to the Utah paradigm: Insights about bone physiology and its clinical applications

2001

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Efforts to understand our anatomy and physiology can involve four often overlapping phases. We study what occurs, then how, then ask why, and then seek clinical applications. In that regard, in 1960 views, bone's effector cells (osteoblasts and osteoclasts) worked chiefly to maintain homeostasis under the control of nonmechanical agents, and that physiology had little to do with anatomy, biomechanics, tissue-level things, muscle, and other clinical applications. But it seems later-discovered tissue-level mechanisms and functions (including biomechanical ones, plus muscle) are the true key players in bone physiology, and homeostasis ranks below the mechanical functions. Adding that information to earlier views led to the Utah paradigm of skeletal physiology that combines varied anatomical, clinical, pathological, and basic science evidence and ideas. While it explains in a general way how strong muscles make strong bones and chronically weak muscles make weak ones, and while many anatomists know about the physiology that fact depends on, poor interdisciplinary communication left people in many other specialties unaware of it and its applications. Those applications concern 1.) healing of fractures, osteotomies, and arthrodeses; 2.) criteria that distinguish mechanically competent from incompetent bones; 3.) design criteria that should let load-bearing implants endure; 4.) how to increase bone strength during growth, and how to maintain it afterwards on earth and in microgravity situations in space; 5.) how and why healthy women only lose bone next to marrow during menopause; 6.) why normal bone functions can cause osteopenias; 7.) why whole-bone strength and bone health are different matters; 8.) why falls can cause metaphyseal and diaphyseal fractures of the radius in children, but mainly metaphyseal fractures of that bone in aged adults; 9.) which methods could best evaluate whole-bone strength, "osteopenias" and "osteoporoses"; 10.) and why most "osteoporoses" should not have bone-genetic causes and some could have extraosseous genetic causes. Clinical specialties that currently require this information include orthopaedics, endocrinology, radiology, rheumatology, pediatrics, neurology, nutrition, dentistry, and physical, space and sports medicine. Basic science specialties include absorptiometry, anatomy, anthropology, biochemistry, biomechanics, biophysics, genetics, histology, pathology, pharmacology, and cell and molecular biology. This article reviews our present general understanding of this new bone physiology and some of its clinical applications and implications. It must leave to other times, places, and people the resolution of questions about that new physiology, and to understand the many devils that should lie in its details. (Thompson D'Arcy, 1917). Anat Rec 262: 2001.

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“…We observed stable osseous ingrowth in all femoral components at revision and at the latest followup in our patients. Polyethylene wear is directly correlated to the occurrence and progression of osteolysis [14,25,26]. Advances in polyethylene preparation have resulted in the development of highly cross-linked polymers that have substantially reduced secondary oxidation and wear of polyethylene in the laboratory [20] and clinically [7].…”

Section: Discussionmentioning

confidence: 99%

Femoral Osteolysis Around the Unrevised Stem During Isolated Acetabular Revision

Min

Song

Cho

et al. 2008

Clin Orthop Relat Res

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Many surgeons treat progressive femoral osteolysis in association with a well-fixed stem with bone grafting but in uncontained proximal defects the graft could get into the joint, raising a question regarding whether the osteolysis can be treated by simple débridement without bone grafting. We investigated whether the curetted proximal osteolysis around an unrevised femoral component progressed in size and whether this lesion would have a deleterious effect on fixation of the femoral component in patients with isolated acetabular revision. We prospectively followed 21 patients (24 hips) who underwent acetabular revision and curetting of femoral osteolysis. The minimum followup was 3 years (mean, 4.3 years; range, 3-7

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Etiology of Osteolysis Around Porous-Coated Cementless Total Hip Arthroplasties

Cited by 88 publications

References 0 publications

Polyethylene cross‐linking by two different methods reduces acetabular liner wear in a hip joint wear simulator

Polyethylene cross‐linking by two different methods reduces acetabular liner wear in a hip joint wear simulator

From Wolff's law to the Utah paradigm: Insights about bone physiology and its clinical applications

Femoral Osteolysis Around the Unrevised Stem During Isolated Acetabular Revision

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