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Acetabular Polyethylene Wear and Acetabular Inclination and Femoral Offset

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Clinical Orthopaedics and Related Research®

Abstract

Restoration of femoral offset and acetabular inclination may have an effect on polyethylene (PE) wear in THA. We therefore assessed the effect of femoral offset and acetabular inclination (angle) on acetabular conventional (not highly cross-linked) PE wear in uncemented THA. We prospectively followed 43 uncemented THAs for a minimum of 49 months (mean, 64 months; range, 49–88 months). Radiographs were assessed for femoral offset, acetabular inclination, and conventional PE wear. The mean (± standard deviation) linear wear rate in all THAs was 0.14 mm/year (± 0.01 mm/year) and the mean volumetric wear rate was 53.1 mm3/year (± 5.5 mm3/year). In THAs with an acetabular angle less than 45°, the mean wear was 0.12 mm/year (± 0.01 mm/year) compared with 0.18 mm/year (± 0.02 mm/year) in those with a reconstructed acetabular angle greater than 45°. Reproduction of a reconstructed femoral offset to within 5 mm of the native femoral offset was associated with a reduction in conventional PE wear (0.12 mm/year versus 0.16 mm/year). Careful placement of the acetabular component to ensure an acetabular angle less than 45° in the reconstructed hip allows for reduced conventional PE wear.

Level of Evidence: Level II, prospective study. See Guidelines for Authors for a complete description of levels of evidence.

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References

  1. Bankston AB, Cates H, Ritter MA, Keating EM, Faris PM. Polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res. 1995;317:7–13.

    PubMed  Google Scholar 

  2. Bankston AB, Faris PM, Keating EM, Ritter MA. Polyethylene wear in total hip arthroplasty in patient-matched groups: a comparison of stainless steel, cobalt chrome, and titanium-bearing surfaces. J Arthroplasty. 1993;8:315–322.

    Article  PubMed  CAS  Google Scholar 

  3. Barrack RL. Factors influencing polyethylene wear in total joint arthroplasty. Orthopedics. 1998;21:937–940.

    PubMed  CAS  Google Scholar 

  4. Charles MN, Bourne RB, Davey JR, Greenwald AS, Morrey BF, Rorabeck CH. Soft-tissue balancing of the hip: the role of femoral offset restoration. Instr Course Lect. 2005;54:131–141.

    PubMed  Google Scholar 

  5. Del Schutte H Jr, Lipman AJ, Bannar SM, Livermore JT, Ilstrup D, Morrey BF. Effects of acetabular abduction on cup wear rates in total hip arthroplasty. J Arthroplasty. 1998;13:621–626.

    Article  PubMed  Google Scholar 

  6. Devane PA, Horne JG. Assessment of polyethylene wear in total hip replacement. Clin Orthop Relat Res. 1999;369:59–72.

    Article  PubMed  Google Scholar 

  7. Eggli S, z’Brun S, Gerber C, Ganz R. Comparison of polyethylene wear with femoral heads of 22 mm and 32 mm: a prospective, randomised study. J Bone Joint Surg Br. 2002;84:447–451.

    Article  PubMed  CAS  Google Scholar 

  8. Gaffey JL, Callaghan JJ, Pedersen DR, Goetz DD, Sullivan PM, Johnston RC. Cementless acetabular fixation at fifteen years: a comparison with the same surgeon’s results following acetabular fixation with cement. J Bone Joint Surg Am. 2004;86:257–261.

    PubMed  Google Scholar 

  9. Glyn-Jones S, Lardy-Smith P, Gill HS, Murray DW. The creep and wear of highly cross-linked polyethylene: a three-year randomised, controlled trial using radiostereometric analysis. J Bone Joint Surg Br. 2008;90:556–561.

    Article  PubMed  CAS  Google Scholar 

  10. Goosen JH, Verheyen CC, Tulp NJ. Mid-term wear characteristics of an uncemented acetabular component. J Bone Joint Surg Br. 2005;87:1475–1479.

    Article  PubMed  CAS  Google Scholar 

  11. Hansen T, Otto M, Buchhorn GH, Scharnweber D, Gaumann A, Delank KS, Eckardt A, Willert HG, Kriegsmann J, Kirkpatrick CJ. New aspects in the histological examination of polyethylene wear particles in failed total joint replacements. Acta Histochem. 2002;104:263–269.

    Article  PubMed  Google Scholar 

  12. Hirakawa K, Mitsugi N, Koshino T, Saito T, Hirasawa Y, Kubo T. Effect of acetabular cup position and orientation in cemented total hip arthroplasty. Clin Orthop Relat Res. 2001;388:135–142.

    Article  PubMed  Google Scholar 

  13. Howie DW, Vernon-Roberts B, Oakeshott R, Manthey B. A rat model of resorption of bone at the cement-bone interface in the presence of polyethylene wear particles. J Bone Joint Surg Am. 1988;70:257–263.

    PubMed  CAS  Google Scholar 

  14. Johnsen SP, Sorensen HT, Lucht U, Soballe K, Overgaard S, Pedersen AB. Patient-related predictors of implant failure after primary total hip replacement in the initial, short- and long-terms: a nationwide Danish follow-up study including 36,984 patients. J Bone Joint Surg Br. 2006;88:1303–1308.

    Article  PubMed  CAS  Google Scholar 

  15. Kligman M, Michael H, Roffman M. The effect of abduction differences between cup and contralateral acetabular angle on polyethylene component wear. Orthopedics. 2002;25:65–67.

    PubMed  CAS  Google Scholar 

  16. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978;60:217–220.

    PubMed  CAS  Google Scholar 

  17. Livermore J, Ilstrup D, Morrey B. Effect of femoral head size on wear of the polyethylene acetabular component. J Bone Joint Surg Am. 1990;72:518–528.

    PubMed  CAS  Google Scholar 

  18. Martell JM, Berdia S. Determination of polyethylene wear in total hip replacements with use of digital radiographs. J Bone Joint Surg Am. 1997;79:1635–1641.

    PubMed  CAS  Google Scholar 

  19. McCalden RW, Naudie DD, Yuan X, Bourne RB. Radiographic methods for the assessment of polyethylene wear after total hip arthroplasty. J Bone Joint Surg Am. 2005;87:2323–2334.

    Article  PubMed  Google Scholar 

  20. Nogler M, Kessler O, Prassl A, Donnelly B, Streicher R, Sledge JB, Krismer M. Reduced variability of acetabular cup positioning with use of an imageless navigation system. Clin Orthop Relat Res. 2004;426:159–163.

    Article  PubMed  Google Scholar 

  21. Patil S, Bergula A, Chen PC, Colwell CW Jr, D’Lima DD. Polyethylene wear and acetabular component orientation. J Bone Joint Surg Am. 2003;85(suppl 4):56–63.

    PubMed  Google Scholar 

  22. Robinson RP, Simonian PT, Gradisar IM, Ching RP. Joint motion and surface contact area related to component position in total hip arthroplasty. J Bone Joint Surg Br. 1997;79:140–146.

    Article  PubMed  CAS  Google Scholar 

  23. Sakalkale DP, Sharkey PF, Eng K, Hozack WJ, Rothman RH. Effect of femoral component offset on polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res. 2001;388:125–134.

    Article  PubMed  Google Scholar 

  24. Schmalzried TP, Huk OL. Patient factors and wear in total hip arthroplasty. Clin Orthop Relat Res. 2004;418:94–97.

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank Dr. J. Martell for help in obtaining radiographic measurements.

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Authors and Affiliations

  1. Epsom General Hospital, Dorking Road, Epsom, Surrey, KT18 7EG, UK

    Nick J. Little MSc, MRCS

  2. Rowley Bristow Orthopaedic Unit , St Peters Hospital, Chertsey, Surrey, UK

    Constant A. Busch MD, FRCS

  3. Queensland Knee Surgery Clinic, Brisbane, Australia

    John A. Gallagher MD, FRACS

  4. London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

    Cecil H. Rorabeck MD, FRCSC & Robert B. Bourne MD, FRCSC

Authors
  1. Nick J. Little MSc, MRCS
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  2. Constant A. Busch MD, FRCS
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  3. John A. Gallagher MD, FRACS
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  4. Cecil H. Rorabeck MD, FRCSC
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  5. Robert B. Bourne MD, FRCSC
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Corresponding author

Correspondence to Nick J. Little MSc, MRCS.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at University of Western Ontario.

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Little, N.J., Busch, C.A., Gallagher, J.A. et al. Acetabular Polyethylene Wear and Acetabular Inclination and Femoral Offset. Clin Orthop Relat Res 467, 2895–2900 (2009). https://doi.org/10.1007/s11999-009-0845-3

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  • DOI: https://doi.org/10.1007/s11999-009-0845-3

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