scholarly journals The Wear Rate and Survivorship in Total Hip Arthroplasty using a Third- Generation Ceramic Head on a Conventional Polyethylene liner: A Minimum of 15-year Follow-up

2021 ◽  
Author(s):  
Bum-Jin Shim ◽  
Chang Hyun Choi ◽  
Inha Woo ◽  
Chan Ho Park
Keyword(s):  
Total Hip Arthroplasty ◽  
Wear Rate ◽  
Hip Arthroplasty ◽  
The United States ◽  
Polyethylene Liner ◽  
Linear Wear ◽  
Third Generation ◽  
Ceramic Head ◽  
Total Hip

Abstract Background: Recently, the use of ceramic-on-polyethylene (CoP) bearing surfaces has increased in the United States with the development of material properties. However, it remains controversial which bearing couples are effective. The purpose of this study was to evaluate the wear and survival rates of third-generation ceramic heads on a conventional polyethylene liner. Methods: We retrospectively reviewed 160 hips (147 patients with a mean age of 56 years) who underwent total hip arthroplasty using the third-generation ceramic head on a conventional polyethylene liner from March 1998 to August 2003. The wear rate was evaluated using the PolyWare program Version 8 (Draftware Developers Inc., IN, USA) in 32 hips followed-up for at least 15 years. In addition, we evaluated the Kaplan-Meier survivorship.Results: Linear wear and volumetric wear rates were 0.102±0.57 mm/year and 30.2±27.5 mm3/year, respectively. Fourteen reoperations due to all causes and 10 revisions were performed during the follow-up period. The 15-year survival rate was 84.1% for any surgery as the endpoint and 87.6% for the revision surgery as the endpoint. Most of the causes of revision were cup loosening, and no ceramic head fracture occurred.Conclusions: The CoP bearing surface maintains the advantages of the soft polyethylene surface and has good resistance to wear. Therefore, alumina ceramic on newer polyethylene could certainly be a good alternative bearing couple without any concern for ceramic fractures, especially in younger patients.Level of evidence: Level III, retrospective cohort design

Mid- to Long-Term Survivorship Analysis of a Second-Generation Highly Cross-Linked Polyethylene in Total Hip Arthroplasty

2020 ◽  
Vol 4 (03) ◽  
pp. 124-128
Author(s):  
David Yeroushalmi ◽  
Katherine A. Lygrisse ◽  
Mohamad Sharan ◽  
Nolan A. Maher ◽  
Joseph D. Zuckerman ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Wear Rate ◽  
Hip Arthroplasty ◽  
Second Generation ◽  
Abduction Angle ◽  
Linear Wear ◽  
Wear Rates ◽  
Total Hip

AbstractThe emergence of highly cross-linked polyethylene (HCLPE) has drastically improved survivorship of implants used in total hip arthroplasty (THA), as demonstrated by midterm outcomes. However, there is limited data evaluating long-term outcomes and wear rates of these liners. Therefore, the aim of this study is to evaluate the longest-to-date follow-up of a specific second-generation HCLPE liner, the progression of wear rate, and its relation to acetabular cup positioning. A retrospective study was conducted on patients who underwent THA between January 2001 and December 2005 using a specific second-generation HCLPE liner. Annual liner wear rate (mm/year) was calculated in this group as well as acetabular positioning through abduction angle (degrees). Failures and reason for failures such as periprosthetic fracture, dislocation, and osteolysis were noted when applicable. Forty hips of 35 patients were included in this study with a clinical and radiographic follow-up of 13.4 ± 2.2 years (range: 10.0–16.7 years). Linear and volumetric wear rates were calculated to be 0.037 ± 0.020 mm/year and 22.94 ± 12.07 mm3/year, respectively. No radiographic femoral or acetabular osteolysis was observed in any of the cases. One patient required revision due to complications unrelated to the liner. No significant relationship could be established for acetabular component abduction angle and linear wear rate (p = 0.690, Spearman's rho = 0.03). Our study demonstrates comparable liner wear rates to that of other second-generation HCLPE liners in long-term follow-up. The XLPE liner continues to exhibit minimal progression of linear wear when compared with previous midterm studies and maintains a low rate of postoperative complications requiring revision THA surgery. Further studies are warranted to assess long-term wear and survivorship between this specific liner and comparable HCLPE models.

scholarly journals Long-term performance of oxidized zirconium on conventional and highly cross-linked polyethylene in total hip arthroplasty

SICOT-J ◽  
2020 ◽  
Vol 6 ◽  
pp. 10 ◽  
Author(s):  
Alberto V. Carli ◽  
Anay R. Patel ◽  
Michael B. Cross ◽  
David J. Mayman ◽  
Kaitlin M. Carroll ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Wear Rate ◽  
Hip Arthroplasty ◽  
Linear Wear ◽  
Wear Rates ◽  
Linear Wear Rate ◽  
Total Hip ◽  
Oxidized Zirconium

Introduction: Polyethylene wear and subsequent osteolysis remain obstacles to the long-term survivorship of total hip arthroplasty (THA). Highly cross-linked polyethylene (XLPE) with radical quenching represents a massive leap forward with dramatically improved wear rates compared to ultra-high molecular weight polyethylene (UHMWPE). In this study we evaluate the wear of UHMWPE and XLPE coupled with oxidized zirconium (OxZr) femoral heads. Methods: A longitudinal, retrospective analysis was performed identifying consecutive patients who received a 28-mm OxZr-on-polyethylene primary THA from 2003 to 2004 by a single, high-volume arthroplasty surgeon. Patients were divided into two groups: those that received (1) UHMWPE liner and (2) a highly XLPE liner. Patients were included if clinical follow-up was complete to 2014 or later. Radiographic analysis was performed by two blinded observers. Measures included cup position, annual linear wear rate, and presence of osteolysis. Pairwise comparisons, correlations, and inter-rater reliability were calculated. Results: Eighty patients were in the UHMWPE group with an average follow-up of 10 ± 1.23 years and 88 patients in the XLPE group with an average of 10 ± 1.03-year follow-up. Average age (68) was similar between groups (p = 0.288). Observer reliability was excellent for cup abduction (ICC = 0.940), anteversion (ICC = 0.942), and detection of osteolysis (ICC = 0.811). Annual linear wear rates were significantly higher (p = 1 × 10−19) with UHMWPE (0.21 ± 0.12 mm/year) compared to XLPE (0.05 ± 0.03 mm/year). Linear wear rate was significantly correlated to decreasing acetabular abduction (p = 0.035). Osteolysis was noted only in the UHMWPE group, with 17 patients (21.2%) exhibiting acetabular osteolysis and 37 (46.3%) patients exhibiting femoral osteolysis. Conclusions: OxZr coupled with XLPE showed minimal wear and no osteolysis at 10-year follow up. The yearly linear penetration rate is similar to that seen in other studies of XLPE THA. A careful longitudinal follow-up will be required to determine if advanced bearings such as OxZr or ceramic can show improved performance in the second decade of implantation.

scholarly journals Isolated Fracture of the Ceramic Head After Third-Generation Alumina-on-Alumina Total Hip Arthroplasty

2008 ◽  
Vol 90 (2) ◽  
pp. 329-336 ◽  
Author(s):  
Kyung-Hoi Koo ◽  
Yong-Chan Ha ◽  
Woon Hwa Jung ◽  
Sang-Rim Kim ◽  
Jeong Joon Yoo ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Third Generation ◽  
Ceramic Head ◽  
Total Hip ◽  
Isolated Fracture

Total hip arthroplasty using highly cross-linked polyethylene in patients aged 50 years and younger

2021 ◽  
Vol 103-B (7 Supple B) ◽  
pp. 78-83 ◽  
Author(s):  
Gordon G. Roedel ◽  
Beau J. Kildow ◽  
Daniel S. Sveom ◽  
Kevin L. Garvin
Keyword(s):  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Polyethylene Wear ◽  
Prognostic Significance ◽  
Head Size ◽  
Linear Wear ◽  
Total Hip ◽  
Radiolucent Lines

Aims Highly cross-linked polyethylene (HXLPE) has greatly improved the durability of total hip arthroplasty (THA) in young patients because of its improved wear characteristics. Few studies have followed this population into the second decade, and therefore the purpose of this investigation was to evaluate the clinical outcome for THA patients 50 years of age and younger at a minimum of 15 years postoperatively. The second purpose was to evaluate the radiological findings secondary to wear or mechanical failure of the implant. Methods Between October 1999 and December 2005, 105 THAs were performed in 95 patients (53 female, 42 male) aged 50 years and younger (mean 42 years (20 to 50)). There were 87 patients (96 hips) that were followed for a minimum of 15 years (mean 17.3 years (15 to 21)) for analysis. Posterior approach was used with cementless fixation with a median head size of 28 mm. HXLPE was the acetabular bearing for all hips. Radiographs were evaluated for polyethylene wear, radiolucent lines, and osteolysis. Results Clinical outcomes showed significant improvement of mean Harris Hip Scores from 52.8 (SD 13.5) preoperatively to 94.8 (SD 7.6) postoperatively. One hip was revised for recurrent instability, and there were no infections. No hips were revised for mechanical loosening or osteolysis. Mean polyethylene linear wear was 0.04 mm/year and volumetric wear was 6.22 mm3/year, with no significant differences between head size or material. Osteolysis was not present in any of the hips. Conclusion The use of HXLPE in THA for patients aged 50 years and younger has performed exceptionally well without evidence of significant wear causing mechanical loosening or necessitating revision. The radiolucent lines of the acetabular component must be followed to determine the prognostic significance. This investigation represents the longest clinical follow-up of a large, consecutive cohort of patients aged 50 years or younger with THA using HXLPE. This long-term analysis found negligible polyethylene wear, no incidence of aseptic loosening, and excellent clinical outcomes at and beyond 15 years of follow-up. Cite this article: Bone Joint J 2021;103-B(7 Supple B):78–83.

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

Arthroplasty ◽  
2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Seung-Jae Lim ◽  
Ingwon Yeo ◽  
Chan-Woo Park ◽  
Kyung-Jae Lee ◽  
Byung-Woo Min ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Polyethylene Liner ◽  
Harris Hip Score ◽  
Revision Total Hip Arthroplasty ◽  
Revision Thas ◽  
Total Hip ◽  
The Mean

Abstract 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 cross-linked 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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