Minimum 10-Year Wear Analysis of Highly Cross-Linked Polyethylene in Cementless Total Hip Arthroplasty

So, KF; Goto, Koji; Kuroda, Yutaka; Matsuda, Shuichi

doi:10.1016/j.arth.2015.06.053

Cited by 24 publications

(15 citation statements)

References 31 publications

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“…12 (p ≥ 0.40). Further, a controversial topic is the argument for [54][55][56][57][58] or against [30,[59][60][61][62][63] compared head penetration rates of irradiated and remelted HXLPE (0.032mm/year) and onceannealed HXLPE (0.031 mm/year) using all 26mm CoCr heads at 8.2 years follow-up and showed equivalent head penetration rates [49] which corroborate previous studies with different femoral head sizes, materials and polyethylene thickness. [48,64] Still, Snir and colleagues found the wear rate at 10 years for this once-annealed polyethylene bearing against a 28mm…”

Section: Accepted Manuscriptsupporting

confidence: 75%

Femoral Head Penetration Rates of Second-Generation Sequentially Annealed Highly Cross-Linked Polyethylene at Minimum Five Years

Deckard

Meneghini

2019

The Journal of Arthroplasty

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Background: Highly cross-linked polyethylene (HXLPE) liners in total hip arthroplasty (THA) have demonstrated decreased wear rates, resilience to cup orientation, and reduced osteolysis compared to conventional polyethylene. Sequential irradiation and annealing below the melting temperature is unique compared to most HXLPE which is irradiated and remelted. This study purpose was to provide minimum five-year femoral head penetration rates of sequentially annealed HXLPE in primary THA. Methods: A retrospective review of a prospectively collected database identified 198 consecutive, cementless primary THAs utilizing sequentially annealed HXLPE (X3 ™ , Stryker, Mahwah, NJ). Operative technique was standardized. Radiographs were analyzed utilizing the Martell method with minimum five-year and one-year radiographs as baseline to minimize the initial bedding-in period. Results: Seventy-seven hips with minimum five-year follow-up were analyzed. Mean steadystate linear and volumetric head penetration rates were 0.095 mm/year and 76 mm 3 /year. Volumetric head penetration was significantly less for 32mm compared to 36mm (p=0.028). In addition, less head penetration was observed for ceramic 32mm heads at nearly half the rate compared to CoCr 36mm heads (p≥0.092). No correlations existed between penetration rates and age, BMI, UCLA Activity Level, polyethylene thickness, cup inclination or anteversion (p≥0.10). No radiographic osteolysis was observed. Conclusion: Surprisingly, linear head penetration rates of sequentially annealed HXLPE were nearly identical to the osteolysis threshold for conventional polyethylene and greater than reports of irradiated and remelted HXLPE. Further, this data corroborates reports that HXLPE is resilient to cup orientation and demographic variables. Longer term follow-up is recommended.

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Section: Accepted Manuscriptsupporting

confidence: 75%

Femoral Head Penetration Rates of Second-Generation Sequentially Annealed Highly Cross-Linked Polyethylene at Minimum Five Years

Deckard

Meneghini

2019

The Journal of Arthroplasty

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“…HXLPE liners have been developed with improved resistance to wear and fewer wear particles generated in vitro [5,6]. Several authors have studied the durability of HXLPE bearings in hip arthroplasty and reported favorable radiographic and clinical outcomes of HXLPE bearings in primary settings [7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

“…Highly cross-linked polyethylene (HXLPE) materials are developed specifically to reduce polyethylene wear and subsequent wear debris-induced osteolysis. Previous studies have clearly shown that HXLPE liners in primary THA have superior in vitro [5,6] wear rates and midterm to long-term in vivo [7][8][9] wear rates. Recently, Feng et al [10] have shown excellent clinical results of cementless THAs using HXLPE liner with a mean 12.9year postoperative follow-up (range, 7-18 years), demonstrating the potential benefits of this new material in providing longevity even to revision settings.…”

Section: Introductionmentioning

confidence: 96%

High survivorship of highly cross-linked polyethylene in revision Total hip Arthroplasty: a minimum 10-year follow-up study

Lim¹,

Yeo²,

Park

et al. 2019

Arthroplasty

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Purpose: Highly cross-linked polyethylene has been introduced to decrease osteolysis secondary to polyethylene wear debris generation. However, few long-term data on revision total hip arthroplasty (THA) using highly crosslinked polyethylene liners are available. The objective of this study was to determine long-term outcomes of a highly cross-linked polyethylene liner in revision THA. Materials & methods: We evaluated 63 revision THAs performed in 63 patients using a highly cross-linked polyethylene liner between April 2000 and February 2005. Of these, nine died and four were lost to follow-up. Thus, the final study cohort consisted of 50 patients (50 hips), including 26 males and 24 females with a mean age of 53 years (range, 27-75 years). Mean follow-up was 11 years (range, 10-14 years). Results: The mean Harris hip score improved from 44 points preoperatively to 85 points at the final follow-up. No radiographic evidence of osteolysis was found in any hip. The mean rate of polyethylene liner wear was 0.029 mm/year (range, 0.003 to 0.098 mm/year). A total of 5 hips (10%) required re-revision arthroplasty, including one cup loosening, one recurrent dislocation, and three deep infections. Kaplan-Meier survivorship with an end point of re-revision for any reason was 91.1% and for aseptic cup loosening was 97.9% at 11 years. Conclusion: At a minimum of 10 years, the highly cross-linked polyethylene liners showed excellent clinical performance and implant survivorship, and were not associated with osteolysis in our patients with revision THAs.

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“…The total head penetration is thought to be a combination of the true wear plus the plastic deformation that occurs up to two-years reported in the literature. [4,[23][24][25] Further, a controversial topic is the argument for [26][27][28][29][30][31][32][33] or against [34][35][36][37][38][39][40] the effect of the polyethylene thickness on the plastic deformation and wear occurring in THA and conclusive evidence is lacking. Retrieval analyses would be required to confirm the amount of wear, the wear path characterization and the amount of plastic deformation in these more complex bearings to include both the convex and concave surfaces.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Contemporary Dual Mobility Head Penetration at Five Years: Concern for the Additional Convex Bearing Surface?

Deckard

Azzam

Meneghini

2018

The Journal of Arthroplasty

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Minimum 10-Year Wear Analysis of Highly Cross-Linked Polyethylene in Cementless Total Hip Arthroplasty

Cited by 24 publications

References 31 publications

Femoral Head Penetration Rates of Second-Generation Sequentially Annealed Highly Cross-Linked Polyethylene at Minimum Five Years

Femoral Head Penetration Rates of Second-Generation Sequentially Annealed Highly Cross-Linked Polyethylene at Minimum Five Years

High survivorship of highly cross-linked polyethylene in revision Total hip Arthroplasty: a minimum 10-year follow-up study

Contemporary Dual Mobility Head Penetration at Five Years: Concern for the Additional Convex Bearing Surface?

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