Midterm Results of Primary Total Hip Arthroplasty Using Highly Cross-Linked Polyethylene

Background High prosthesis survival is reported for total hip prostheses with metal and alumina heads, but direct comparisons of a single prosthesis design with one of two different head materials has seldom been studied. Prostheses with zirconia heads are less commonly used than metal and alumina heads, and the few reports suggest variable results with zirconia heads.Questions/Purposes We therefore asked: (1) Would metal heads provide better survival of a cemented total hip arthroplasty (THA) than alumina heads? (2) Would metal heads provide better survival of a cemented THA than zirconia heads? Methods We searched in the Norwegian Arthroplasty Register for cemented primary THA cup/stem combinations that simultaneously had been used with different head materials. The only THA that fulfilled these inclusion criteria was the cemented Reflection All-Poly/ Spectron EF (cup/stem) that had during 2001 to 2006 been used both with alumina (n = 448) and cobaltchromium (n = 5229) heads; that implant had also been used with zirconia (n = 275) and cobalt-chromium heads (n = 3195) during 1997 to 2003, and we included patients with this THA from these two time intervals in the study. All cups were conventional polyethylene. We estimated prosthesis survival and relative revision risks adjusting for age, sex, and diagnosis. The followup in the two study materials was until December 2010.

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“…However, the long-term survival of implants with this increasingly used material is not known [2,7,22,28].…”

Section: Introductionmentioning

confidence: 99%

Head Material Influences Survival of a Cemented Total Hip Prosthesis in the Norwegian Arthroplasty Register

Kadar

Dybvik

Hallan

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Mechanical weakness of conventional polyethylene resulting from sterilization processes also can contribute to an increased risk of prosthetic failure [19,25,28]. Higher failure rates also have been associated with acetabular component malposition, younger age, and male gender [6,21,29]. Although mid-term followup of cross-linked polyethylene bearings suggests that clinically important periprosthetic osteolysis will be rare during the first decade after THA [3,9,17], longer followup is needed to determine that early results will be sustained into the second decade.…”

Section: Discussionmentioning

confidence: 99%

Is Routine Mid-term Total Hip Arthroplasty Surveillance Beneficial?

Keeney

Ellison

Maloney

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Routine followup of patients after primary or revision THA is commonly practiced and driven by concerns that delays in identifying early failure will result in more complicated or more costly surgical interventions. Although mid-term followup (4-10 years) has been performed to follow cohorts of patients, the benefit of observing individual patients regardless of symptoms has not been established. Questions/purposes We determined (1) the reasons patients with THA return for mid-term followup, (2) the treatment recommendations and interventions occurring as a result of mid-term followup, and (3) how frequently revision surgery is recommended for asymptomatic and symptomatic patients at mid-term followup. Methods We retrospectively identified 501 patients (503 hips) who returned for followup at least 4 years (mean, 5 years; range, 4-10.9 years) after their primary or revision THA. We recorded their reasons for followup and treatment recommendations, including those for revision surgery, at mid-term followup.

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“…After a minimum follow-up of 5 years, they found a 100 % survivorship, a mean HHS of 93 points (range, 77 to 98 points), and a mean liner polyethylene wear of 0.037 mm/year. Similarly, Lee et al [49] assessed the survivorship and outcomes of a similar cohort of patients who underwent THA using a highly cross-linked polyethylene component (n=113 hips). After a mean follow-up of approximately 8 years (range, 7 to 11 years), there was a mean wear rate of 0.031 mm/year and a mean HHS of 93 points (range, 80 to 100 points).…”

Section: Role Of Different Bearing Surfacesmentioning

confidence: 98%

Outcomes of total hip arthroplasty in patients with osteonecrosis of the femoral head—a current review

Pierce

Elmallah

Jauregui

et al. 2015

Curr Rev Musculoskelet Med

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The purpose of this review was to analyze (1) patient-reported outcomes and implant survivorship of osteonecrosis (ON) patients following total hip arthroplasty (THA), (2) if prior hip-preserving procedures influence these outcomes, (3) if resurfacing procedures alter outcomes; and (4) how these outcomes may have been impacted by the choice of different bearing surfaces. Today, with implant innovations such as cementless constructs, ceramic bearing surfaces, and highly cross-linked polyethylene, ON patients derive great benefit and have high survivorship following THA. Most studies have shown that previous hip-preserving procedures do not have a deleterious effect on outcomes. Literature on the use of ceramic and highly cross-linked polyethylene bearing surfaces have shown that these implant designs are useful in younger and more active patients. Future research should evaluate the long-term outcomes and survivorship of these new THA constructs.

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Midterm Results of Primary Total Hip Arthroplasty Using Highly Cross-Linked Polyethylene

Cited by 63 publications

References 29 publications

Head Material Influences Survival of a Cemented Total Hip Prosthesis in the Norwegian Arthroplasty Register

Head Material Influences Survival of a Cemented Total Hip Prosthesis in the Norwegian Arthroplasty Register

Is Routine Mid-term Total Hip Arthroplasty Surveillance Beneficial?

Outcomes of total hip arthroplasty in patients with osteonecrosis of the femoral head—a current review

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