Is the use of thin, highly cross-linked polyethylene liners safe in total hip arthroplasty?

Jauregui, Julio J.; Naziri, Qais; Pierce, Todd P.; Elmallah, Randa K.; Cherian, Jeffrey J.; Delanois, Ronald E.; Mont, Michael A.

doi:10.1007/s00264-015-2841-4

Cited by 19 publications

(16 citation statements)

References 39 publications

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“…Additionally, the nature of retrieval analysis is that all implants in this study had failed; it is not clear what the extent of coating loss is in well-functioning implants. It is also important to note that the extent of wear in contemporary highly cross-linked MOP hips has been favourable [ 32,33 ]; this supports the approach of optimising the polyethylene material used rather than introducing coatings to reduce wear.…”

Section: Discussionmentioning

confidence: 90%

Retrieval analysis of ceramic-coated metal-on-polyethylene total hip replacements

Khatkar

Hothi

Villiers

et al. 2016

International Orthopaedics (SICOT)

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Section: Discussionmentioning

confidence: 90%

Retrieval analysis of ceramic-coated metal-on-polyethylene total hip replacements

Khatkar

Hothi

Villiers

et al. 2016

International Orthopaedics (SICOT)

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“…[142][143][144][145][146][147][148][149][150][151][152] However, crosslinked UHMWPE has low impact resistance and is hence easily breakable, with several published cases of breakage in THA. [153][154][155][156][157][158][159] For the same reason, crosslinked UHMWPE is avoided for total knee arthroplasty (TKA), which involves the convex contact of joint components. Indeed, artificial joint sliding elements pose the major problem of a trade-off between wear resistance and impact resistance, and no UHMWPE material has resolved the issue to date.…”

Section: Nanocarbon Biomaterials Expected For Clinical Application In...mentioning

confidence: 99%

Future Prospects for Clinical Applications of Nanocarbons Focusing on Carbon Nanotubes

et al. 2022

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Over the past 15 years, numerous studies have been conducted on the use of nanocarbons as biomaterials towards such applications as drug delivery systems, cancer therapy, and regenerative medicine. However, the clinical use of nanocarbons remains elusive, primarily due to short‐ and long‐term safety concerns. It is essential that the biosafety of each therapeutic modality be demonstrated in logical and well‐conducted experiments. Accordingly, the fundamental techniques for assessing nanocarbon biomaterial safety have become more advanced. Optimal controls are being established, nanocarbon dispersal techniques are being refined, the array of biokinetic evaluation methods has increased, and carcinogenicity examinations under strict conditions have been developed. The medical implementation of nanocarbons as a biomaterial is in sight. With a particular focus on carbon nanotubes, these perspectives aim to summarize the contributions to date on nanocarbon applications and biosafety, introduce the recent achievements in evaluation techniques, and clarify the future prospects and systematic introduction of carbon nanomaterials for clinical use through practical yet sophisticated assessment methods.

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“…28 On the other hand, the locking mechanism of the thinner first generation HCLPE when used with large diameter heads are considered strong enough, without major concern. 29 The safety of the thin liners has been questioned but current 30 clinical evidence and 31 laboratory studies supports satisfactory survival at short term.…”

Section: Introductionmentioning

confidence: 99%

Low failure rate at short term for 40 mm heads and second generation triple annealed HCLPE liners in hybrid hip replacements

Thangaraj

Kuiper

Perkins

2019

Journal of Clinical Orthopaedics and Trauma

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Introduction: 40 mm large diameter heads offer the advantages of lesser dislocation rates and better stability while highly cross linked polyethylene have lower wear rates than ultra high molecular weight polyethylene. Studies of the survivorship of 40 mm heads in hybrid hip replacements with Exeter stem and second generation highly cross linked polyethylene are limited. The purpose of the study is to report the short term of survivorship of the large diameter heads (40 mm) with Exeter stem with the secondary aim being the survival analysis of the thinnest second generation highly cross linked polyethylene. Methods: Retrospective case series of survivorship of patients with hybrid hip replacements of Exeter stems with 40 mm heads articulating with second generation triple annealed highly cross linked polyethylene liner on a uncemented acetabular shell was performed. As a subset, survival of thinnest second generation highly cross linked polyethylene survival (3.8 mm) at short term was assessed. Survival of the implants was confirmed from the hospital records and National joint registry as of 2015. Revision for any cause was taken as end point. Results: 324 hybrid hip replacements with 40 mm heads had been performed for primary hip osteoarthritis. Of the 324 hip replacements, 154 hip replacements had thinnest second generation highly cross linked polyethylene (3.8 mm). Two patients had revision of components, one for periprosthetic fracture and one for deep infection. Mean age of the patients was 70.5 years (range 42-88 years, median 71, SD 8.3 years). None of the patients had revision due to trunion wear or loosening of components. The overall 5-year implant survival probability of hips with 40 mm heads was 99.4% (95% CI 98 to 100%) while the subset group of hip replacements with thinnest second generation highly cross linked polyethylene (3.8 mm) had 5-year implant survival probability of 99.3% (95% CI 97.1 to 100%). Conclusion: Short term survivorship does not show significant evidence of early failure or higher rate of revision in our series of hybrid hip replacements with large diameter heads and second generation triple annealed highly cross linked polyethylene. Dislocation rate at the short term is none. Results from this series have to be carefully interpreted due to the relatively short follow up but so far results are encouraging. Long term follow up is required to conclude whether there is early or higher rate of failure. It is our intention to follow up this cohort and further publish our results at longer term.

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Is the use of thin, highly cross-linked polyethylene liners safe in total hip arthroplasty?

Abstract: Our results suggest that according to a mean follow-up of 4 years, the use of thin liners in THA is promising. Longer follow-up is required to assess whether these outcomes are observed later.

Cited by 19 publications

References 39 publications

Retrieval analysis of ceramic-coated metal-on-polyethylene total hip replacements

Retrieval analysis of ceramic-coated metal-on-polyethylene total hip replacements

Future Prospects for Clinical Applications of Nanocarbons Focusing on Carbon Nanotubes

Low failure rate at short term for 40 mm heads and second generation triple annealed HCLPE liners in hybrid hip replacements

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Is the use of thin, highly cross-linked polyethylene liners safe in total hip arthroplasty?

Abstract: Our results suggest that according to a mean follow-up of 4 years, the use of thin liners in THA is promising. Longer follow-up is required to assess whether these outcomes are observed later.

Cited by 19 publications

References 39 publications

Retrieval analysis of ceramic-coated metal-on-polyethylene total hip replacements

Retrieval analysis of ceramic-coated metal-on-polyethylene total hip replacements

Future Prospects for Clinical Applications of Nanocarbons Focusing on Carbon Nanotubes

Low failure rate at short term for 40 mm heads and second generation triple annealed HCLPE liners in hybrid hip replacements

Contact Info

Product

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Low failure rate at short term for 40 mm heads and second generation triple annealed HCLPE liners in hybrid hip replacements