Abstract
Cross-linked polyethylene (PE) for total hip arthroplasty still lacks long-term clinical evidence about its sustained performance in wear reduction and its effect on reducing osteolysis, while concerns persist about oxidation and the higher osteolytic potential of the wear debris.
This 13 years follow-up of a randomized controlled trial (n48 patients) compares the first generation of a moderately cross-linked and annealed PE (Stryker Duration) to conventional, now “historic” PE by measuring wear as linear head penetration (Roman V 1.70) and counting osteolytic cysts on digital radiographs.
Wear rates were significantly (p = 0.005) lower for Duration (0.063 ± 0.027 mm/year) than conventional PE (0.122 ± 0.065 mm/year). This reduction (−48%) compared well to the original simulator prediction (−45%) and even increased with time (−30% at 5 years, −38% at 8 years, −42% at 10 years). Acetabular cysts were less frequent in the Duration (4/13 = 31%) than in conventional group (13/18 = 72%, p = 0.023).
No evidence of oxidative degradation or elevated osteolytic potential of the wear debris was found but reduced wear and less osteolysis at long follow-up.
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Abbreviations
- AP:
-
Anteroposterior
- HXLPE:
-
Highly cross-linked polyethylene
- LAT:
-
Lateral
- RCT:
-
Randomized controlled trial
- PE:
-
Polyethylene
- SD:
-
Standard deviation
- UHMWPE:
-
Ultra-high molecular weight polyethylene
References
Barrack RL, Folgueras A, Munn B, Tvetden D, Sharkey P (1997) Pelvic lysis and polyethylene wear at 5–8 years in an uncemented total hip. Clin Orthop Relat Res 335:211–217
Capello WN, D’Antonio JA, Ramakrishnan R, Naughton M (2011) Continued improved wear with an annealed highly cross-linked polyethylene. Clin Orthop Relat Res 469(3):825–830. doi:10.1007/s11999-010-1556-5
Charnley J, Halley DK (1975) Rate of wear in total hip replacement. Clin Orthop 112:170
DeLee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121:20–32
Dowd JE, Sychterz CJ, Young AM, Engh CA (2000) Characterization of long-term femoral-head-penetration rates. Association with and prediction of osteolysis. J Bone Joint Surg Am 82-A(8):1102–1107
Dumbleton JH, Manley MT, Edidin AA (2002) A literature review of the association between wear rate and osteolysis in total hip arthroplasty. J Arthroplasty 17:649–661. doi:10.1054/arth.2002.33664
Dumbleton JH, D’Antonio JA, Manley MT, Capello WN, Wang A (2006) The basis for a second-generation highly cross-linked UHMWPE. Clin Orthop Relat Res 453:265–271. doi:10.1097/01.blo.0000238856.61862.7d
Endo M, Tipper JL, Barton DC, Stone MH, Ingham E, Fisher J (2002) Comparison of wear, wear debris and functional biological activity of moderately crosslinked and non-crosslinked polyethylene in hip prostheses. Proc Inst Mech Eng 216 H:111–122. doi:10.1243/0954411021536333
Faul F, Erdfelder E, Lang AG, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39(2):175–191. doi:10.3758/BF03193146
Furmanski J, Anderson M, Bal S, Greenwald AS, Halley D, Penenberg B, Ries M, Pruitt L (2009) Clinical fracture of cross-linked UHMWPE acetabular liners. Biomaterials 30(29):5572–5582. doi:10.1016/j.biomaterials.2009.07.013
Furmanski J, Kraay MJ, Rimnac CM (2011) Crack initiation in retrieved cross-linked highly cross-linked ultrahigh-molecular-weight polyethylene acetabular liners: an investigation of 9 cases. J Arthroplasty 26(5):796–801. doi:10.1016/j.arth.2010.07.016
Geerdink CH, Grimm B, Ramakrishnan R, Rondhuis J, Verburg AJ, Tonino AJ (2006) Crosslinked polyethylene compared to conventional polyethylene in total hip replacement: pre-clinical evaluation, in-vitro testing and prospective clinical follow-up study. Acta Orthop 77(5):719–725. doi:10.1080/17453670610012890
Geerdink CH, Grimm B, Vencken W, Heyligers IC, Tonino AJ (2008) The determination of linear and angular penetration of the femoral head into the acetabular component as an assessment of wear in total hip replacement: a comparison of four computer-assisted methods. J Bone Joint Surg Br 90(7):839–846. doi:10.1302/0301-620X.90B7.20305
Geerdink CH, Grimm B, Vencken W, Heyligers IC, Tonino AJ (2009) Cross-linked compared with historical polyethylene in THA: an 8-year clinical study. Clin Orthop Relat Res 467(4):979–984. doi:10.1007/s11999-008-0628-2
Grimm B (2008) Acetabular PE wear measurement (linear head penetration) using Roman V1.70. http://www.eors.info/Docs/WearRomanManual.pdf. Accessed 7 Nov 2011
Harris WH (2001) Wear and periprosthetic osteolysis: the problem. Clin Orthop Relat Res 393:66–70
Hernigou P, Zilber S, Filippini P, Poignard A (2009) Ceramic-ceramic bearing decreases osteolysis: a 20-year study versus ceramic-polyethylene on the contralateral hip. Clin Orthop Relat Res 467(9):2274–2280. doi:10.1007/s11999-009-0773-2
Kurtz SM (2009) UHMWPE biomaterials handbook – ultra-high molecular weight polyethylene in total joint replacement and medical devices, 2nd edn. Elsevier, San Diego
Kurtz SM, Edidin AA, Bartel DL (1997) The role of backside polishing, cup angle, and polyethylene thickness on the contact stresses in metal-backed acetabular components. J Biomech 30(6):639–642. doi:10.1016/S0021-9290(96)00181-9
Kurtz SM, Gawel HA, Patel JD (2011) History and systematic review of wear and osteolysis outcomes for first-generation highly crosslinked polyethylene. Clin Orthop Relat Res 469(8):2262–2277. doi:10.1007/s11999-011-1872-4
Livermore J, Ilstrup D, Morrey B (1990) Effect of femoral head size on wear of the polyethylene acetabular component. J Bone Joint Surg Am 72(4):518–528
Lundberg HJ, Pedersen DR, Baer TE, Muste M, Callaghan JJ, Brown TD (2007) Effects of implant design parameters on fluid convection, potentiating third-body debris ingress into the bearing surface during THA impingement/subluxation. J Biomech 40(8):1676–1685. doi:10.1016/j.jbiomech.2007.01.021
Marshall A, Ries MD, Paprosky W (2008) Implant Wear Symposium 2007 Clinical Work Group. How prevalent are implant wear and osteolysis, and how has the scope of osteolysis changed since 2000? J Am Acad Orthop Surg 16(Suppl 1):S1–S6
Oral E, Godleski Beckos C, Malhi AS, Muratoglu OK (2008) The effects of high dose irradiation on the cross-linking of vitamin E-blended ultrahigh molecular weight polyethylene. Biomaterials 29(26):3557–3560. doi:10.1016/j.biomaterials.2008.05.004
Schmalzried TP, Brown IC, Amstutz HC, Engh CA, Harris WH (1999) The role of acetabular component screw holes and/or screws in the development of pelvic osteolysis. Proc Inst Mech Eng H 213(2):147–153. doi:10.1243/0954411991534861
Thomas GER, Simpson DJ, Mehmood S, Taylor A, McLardy-Smith P, Gill HS, Murray DW, Glyn-Jones S (2011) The seven-year wear of highly cross-linked polyethylene in total hip arthroplasty: a double-blind, randomized controlled trial using radiostereometric analysis. J Bone Joint Surg Am 93(8):716–722. doi:10.2106/JBJS.J.00287
ASTM F 2183–02 (2003) Test method for small punch testing of ultra-high molecular weight polyethylene used in surgical implants. Annual book of ASTM standards, vol 13.01. ASTM International, West Conshohocken. doi:10.1520/F2183-02R08
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Grimm, B., Tonino, A., Heyligers, I.C. (2012). Long-Term Reduction of Wear and Osteolysis with Cross-Linked PE? 13-Year Follow-up of a Prospectively Randomized Comparison with Conventional PE. In: Knahr, K. (eds) Total Hip Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27361-2_6
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