Increase in early polyethylene wear after sterilization with ethylene oxideRadiostereometric analyses of 201 total hips

Digas, Georgios; Thanner, Jonas; Nivbrant, Bo; Röhrl, Stephan M; Ström, Håkan; Kärrholm, Johan

doi:10.1080/00016470310017910

Cited by 55 publications

(37 citation statements)

References 34 publications

(36 reference statements)

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“…Wear rates of 0.27-0.30 mm at 2 years have been reported for Lubinus cups with CoCr heads (Nivbrant et al 1999, Digas et al 2003 and 0.39 mm at 5 years with Biolox heads (Nivbrant et al 2001) Although 2 cups in our material displayed wear in excess of the respective group mean + 2 SD, the mean wear rate was even lower than what has been previously reported. We found no correlation between excessive wear and increased migration, a finding indicating that the cause of migration and loosening also involves factors other than polyethylene wear.…”

Section: Discussioncontrasting

confidence: 52%

No difference in migration or wear between cemented low-profile cups and standard cups : A randomized radiostereographic study of 53 patients over 3 years

Palm¹,

Olofsson²,

åström³

et al. 2007

Acta Orthopaedica

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Background Minor design changes may cause major changes in implant performance. Thus, as part of a stepwise introduction of a new low-profile cup, we performed a randomized trial comparing it to a well-documented standard cup.Patients and methods 60 patients, stratified according to sex, weight, and age, underwent cemented total hip arthroplasty using a Lubinus SP2 stem with ceramic head and were randomized to either the new low-profile Lubinus Flanged Anti-Luxation cup (FAL) or the Lubinus Standard Eccentric cup (Standard). 7 patients were excluded and 53 (28 FAL) were evaluated at 3, 6, 12, and 36 months postoperatively. Primary outcome variables, cup migration (MTPM), and wear (total 3-dimensional femoral head penetration) were measured with radiostereometry (RSA). Clinical outcome was evaluated with the western Ontario and McMaster osteoarthritis index (Womac) and the visual analog pain score (VAS).Results We found no difference in migration between the FAL and Standard cups. There was no difference in wear between the two cups and there was no correlation between wear and migration. 3 cups (2 FAL and 1 Standard) showed continuous migration of a magnitude that indicated an increased risk of early loosening. Clinical outcome was excellent, without any difference between the 2 groups.

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Section: Discussioncontrasting

confidence: 52%

No difference in migration or wear between cemented low-profile cups and standard cups : A randomized radiostereographic study of 53 patients over 3 years

Palm¹,

Olofsson²,

åström³

et al. 2007

Acta Orthopaedica

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“…This crosslinking has shown great promise in improving the wear profile of polyethylene. This has been demonstrated in the THA literature [6,10,26,27]. In the presence of oxygen, gamma radiation also induces the formation of free radicals, which when combined with oxygen may cause oxidative degradation of polyethylene with age [4,7,8,15,20,45,46].…”

Section: Introductionmentioning

confidence: 82%

“…Crosslinking and thermal stabilization of polyethylene improves wear characteristics of acetabular components in hip simulator studies [27] as well as in vivo radiostereometric analysis [10]. These findings have prompted investigation as to whether crosslinking would be beneficial in TKA.…”

Section: Introductionmentioning

confidence: 99%

Highly Crosslinked Polyethylene is Safe for Use in Total Knee Arthroplasty

Hodrick

Severson

McAlister

et al. 2008

Clinical Orthopaedics &Amp; Related Research

101

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Highly cross-linked polyethylene (XLPE) has been used with good initial success in hip arthroplasty to reduce wear. However, the process of crosslinking reduces fracture toughness, raising concerns as to whether it can be safely used in total knee arthroplasty (TKA). We therefore asked whether XLPE can be used safely in TKA. We performed a retrospective review of 100 subjects receiving XLPE and compared them to 100 subjects who received standard polyethylene in the setting of TKA. The standard polyethylene group had a mean age of 70 with a minimum follow up of 82 months. The highly cross-linked polyethylene group had a mean age of 67 and a minimum follow up of 69 months (mean, 75 months; range, 69-82 months). On radiographic review, the standard group demonstrated 20 TKAs with radiolucencies; 4 of these had evidence of a loose tibial component. The standard group required three revisions related to loose tibial components. The XLPE group had 2 subjects that demonstrated radiolucencies on radiograph and no subjects with evidence of tibial loosening. There were no reoperations related to osteolysis. The data suggest XLPE in TKA can be used safely at least short-to midterm. Our study provides an impetus for further long-term investigation.

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“…Several investigators have reported the wear resistance of gamma-sterilized UHMWPE is better than that of ethylene-oxide-sterilized UHMWPE [5,8,13,14,25]. On the other hand, many previous reports have indicated gamma-sterilized UHMWPE undergoes degradation [2,11,26].…”

Section: Introductionmentioning

confidence: 99%

Oxidation and Wear of 100-Mrad Cross-linked Polyethylene Shelf-aged for 30 Years

Kim

Oonishi

Kyomoto

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Some previous studies suggest that aging influences wear and oxidatively degraded nonsterilized ultra-high-molecular-weight polyethylene (UHMWPE) exhibits decreased wear resistance. We therefore asked whether shelf-aging storage conditions influenced degradation and wear resistance of gamma-irradiated UHMWPE. We examined oxidation and wear of 100-Mrad gamma-irradiated UHMWPE (100-Mrad polyethylene) cups shelf-aged for 30 years without (n = 2) or with (n = 2) packages. The oxidation index of the unpackaged 100-Mrad polyethylene surface (4) was higher than that of the packaged one (2.7). The packaged 100-Mrad polyethylene cup exhibited a high wear resistance with a steady wear rate of 0.5 mg/10 6 cycles. In contrast, the unpackaged 100-Mrad polyethylene exhibited an extremely high initial wear rate of 187.9 mg/10 6 cycles over the first 0.25 · 10 6 cycles with a subsequently reduced wear rate of 5 mg/10 6 cycles after 5 · 10 6 cycles. Packaging over long periods inhibits surface oxidation and maintains the wear resistance of gamma-irradiated UHMWPE cups.

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Increase in early polyethylene wear after sterilization with ethylene oxideRadiostereometric analyses of 201 total hips

Cited by 55 publications

References 34 publications

No difference in migration or wear between cemented low-profile cups and standard cups : A randomized radiostereographic study of 53 patients over 3 years

No difference in migration or wear between cemented low-profile cups and standard cups : A randomized radiostereographic study of 53 patients over 3 years

Highly Crosslinked Polyethylene is Safe for Use in Total Knee Arthroplasty

Oxidation and Wear of 100-Mrad Cross-linked Polyethylene Shelf-aged for 30 Years

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