Advertisement

International Orthopaedics

, Volume 37, Issue 1, pp 9–14 | Cite as

Is there evidence for accelerated polyethylene wear in uncemented compared to cemented acetabular components? A systematic review of the literature

  • Hugo C. van der VeenEmail author
  • Hans-Peter W. van Jonbergen
  • Rudolf W. Poolman
  • Sjoerd K. Bulstra
  • Jos J. A. M. van Raay
Review Article

Abstract

Joint arthroplasty registries show an increased rate of aseptic loosening in uncemented acetabular components as compared to cemented acetabular components. Since loosening is associated with particulate wear debris, we postulated that uncemented acetabular components demonstrate a higher polyethylene wear rate than cemented acetabular components in total hip arthroplasty. We performed a systematic review of the peer-reviewed literature, comparing the wear rate in uncemented and cemented acetabular components in total hip arthroplasty. Studies were identified using MEDLINE (PubMed), EMBASE and the Cochrane Central Register of Controlled Trials. Study quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The search resulted in 425 papers. After excluding duplicates and selection based on title and abstracts, nine studies were found eligible for further analysis: two randomised controlled trials, and seven observational studies. One randomised controlled trial found a higher polyethylene wear rate in uncemented acetabular components, while the other found no differences. Three out of seven observational studies showed a higher polyethylene wear in uncemented acetabular component fixation; the other four studies did not show any differences in wear rates. The available evidence suggests that a higher annual wear rate may be encountered in uncemented acetabular components as compared to cemented components.

Keywords

Wear Rate UHMWPE Aseptic Loosening Acetabular Component Polyethylene Wear 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

We thank Mr. Wieger de Jong, medical librarian at Martini Ziekenhuis Groningen, for assisting in the literature search

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Havelin LI, Fenstad AM, Salomonsson R et al (2009) The Nordic Arthroplasty Register Association: a unique collaboration between 3 national hip arthroplasty registries with 280,201 THRs. Acta Orthop 80:393–401PubMedCrossRefGoogle Scholar
  2. 2.
    Holt G, Murnaghan C, Reilly J et al (2007) The biology of aseptic osteolysis. Clin Orthop Relat Res 460:240–252PubMedGoogle Scholar
  3. 3.
    Ingham E, Fisher J (2005) The role of macrophages in osteolysis of total joint replacement. Biomaterials 26:1271–1286PubMedCrossRefGoogle Scholar
  4. 4.
    Dumbleton JH, D’Antonio JA, Manley MT et al (2006) The basis for a second-generation highly cross-linked UHMWPE. Clin Orthop Relat Res 453:265–271PubMedCrossRefGoogle Scholar
  5. 5.
    Livermore J, Ilstrup D, Morrey B (1990) Effect of femoral head size on wear of the polyethylene acetabular component. J Bone Joint Surg Am 72:518–528PubMedGoogle Scholar
  6. 6.
    Nashed RS, Becker DA, Gustilo RB (1995) Are cementless acetabular components the cause of excess wear and osteolysis in total hip arthroplasty? Clin Orthop Relat Res 317:19–28PubMedGoogle Scholar
  7. 7.
    Little NJ, Busch CA, Gallagher JA et al (2009) Acetabular polyethylene wear and acetabular inclination and femoral offset. Clin Orthop Relat Res 467:2895–2900PubMedCrossRefGoogle Scholar
  8. 8.
    Hailer NP, Garellick G, Karrholm J (2010) Uncemented and cemented primary total hip arthroplasty in the Swedish Hip Arthroplasty Register. Acta Orthop 81:34–41PubMedCrossRefGoogle Scholar
  9. 9.
    Duffy P, Sher JL, Partington PF (2004) Premature wear and osteolysis in an HA-coated, uncemented total hip arthroplasty. J Bone Joint Surg Br 86:34–38PubMedGoogle Scholar
  10. 10.
    Nieuwenhuis JJ, Malefijt Jde W, Hendriks JC et al (2005) Unsatisfactory results with the cementless Omnifit acetabular component due to polyethylene and severe osteolysis. Acta Orthop Belg 71:294–302PubMedGoogle Scholar
  11. 11.
    Hallan G, Lie SA, Havelin LI (2006) High wear rates and extensive osteolysis in 3 types of uncemented total hip arthroplasty: a review of the PCA, the Harris Galante and the Profile/Tri-Lock Plus arthroplasties with a minimum of 12 years median follow-up in 96 hips. Acta Orthop 77:575–584PubMedCrossRefGoogle Scholar
  12. 12.
    Richardson WS, Wilson MC, Nishikawa J et al (1995) The well-built clinical question: a key to evidence-based decisions. ACP J Club 123:A12–A13PubMedGoogle Scholar
  13. 13.
    Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535PubMedCrossRefGoogle Scholar
  14. 14.
    Atkins D, Best D, Briss PA et al (2004) Grading quality of evidence and strength of recommendations. BMJ 328:1490PubMedCrossRefGoogle Scholar
  15. 15.
    Petrisor BA, Keating J, Schemitsch E (2006) Grading the evidence: levels of evidence and grades of recommendation. Injury 37:321–327PubMedCrossRefGoogle Scholar
  16. 16.
    Guyatt GH, Oxman AD, Kunz R et al (2008) Going from evidence to recommendations. BMJ 336:1049–1051PubMedCrossRefGoogle Scholar
  17. 17.
    Digas G, Karrholm J, Thanner J et al (2007) 5-year experience of highly cross-linked polyethylene in cemented and uncemented sockets: two randomized studies using radiostereometric analysis. Acta Orthop 78:746–754PubMedCrossRefGoogle Scholar
  18. 18.
    Clohisy JC, Harris WH (2001) Matched-pair analysis of cemented and cementless acetabular reconstruction in primary total hip arthroplasty. J Arthroplasty 16:697–705PubMedCrossRefGoogle Scholar
  19. 19.
    Onsten I, Carlsson AS, Besjakov J (1998) Wear in uncemented porous and cemented polyethylene sockets: a randomised, radiostereometric study. J Bone Joint Surg Br 80:345–350PubMedCrossRefGoogle Scholar
  20. 20.
    McCombe P, Williams SA (2004) A comparison of polyethylene wear rates between cemented and cementless cups. A prospective, randomised trial. J Bone Joint Surg Br 86:344–349PubMedCrossRefGoogle Scholar
  21. 21.
    Callaghan JJ, Pedersen DR, Olejniczak JP et al (1995) Radiographic measurement of wear in 5 cohorts of patients observed for 5 to 22 years. Clin Orthop Relat Res 317:14–18PubMedGoogle Scholar
  22. 22.
    Gaffey JL, Callaghan JJ, Pedersen DR et al (2004) Cementless acetabular fixation at fifteen years. A comparison with the same surgeon’s results following acetabular fixation with cement. J Bone Joint Surg Am 86-A:257–261PubMedGoogle Scholar
  23. 23.
    Hartofilakidis G, Georgiades G, Babis GC (2009) A comparison of the outcome of cemented all-polyethylene and cementless metal-backed acetabular sockets in primary total hip arthroplasty. J Arthroplasty 24:217–225PubMedCrossRefGoogle Scholar
  24. 24.
    Bjerkholt H, Hovik O, Reikeras O (2010) Direct comparison of polyethylene wear in cemented and uncemented acetabular cups. J Orthop Traumatol 11:155–158PubMedCrossRefGoogle Scholar
  25. 25.
    Kampa RJ, Hacker A, Griffiths E et al (2010) In vivo polyethylene wear of bilateral total hip replacements—cemented versus uncemented modular sockets. Hip Int 20:447–452PubMedGoogle Scholar
  26. 26.
    Chen PC, Mead EH, Pinto JG et al (1995) Polyethylene wear debris in modular acetabular prostheses. Clin Orthop Relat Res 317:44–56PubMedGoogle Scholar
  27. 27.
    Hallan G, Dybvik E, Furnes O et al (2010) Metal-backed acetabular components with conventional polyethylene: a review of 9113 primary components with a follow-up of 20 years. J Bone Joint Surg Br 92:196–201PubMedGoogle Scholar
  28. 28.
    Makela KT, Eskelinen A, Pulkkinen P et al (2008) Total hip arthroplasty for primary osteoarthritis in patients fifty-five years of age or older. An analysis of the Finnish arthroplasty registry. J Bone Joint Surg Am 90:2160–2170PubMedCrossRefGoogle Scholar
  29. 29.
    Graves SE (2010) The value of arthroplasty registry data. Acta Orthop 81:8–9PubMedCrossRefGoogle Scholar
  30. 30.
    Devane PA, Bourne RB, Rorabeck CH et al (1995) Measurement of polyethylene wear in metal-backed acetabular cups. II. Clinical application. Clin Orthop Relat Res 319:317–326PubMedGoogle Scholar
  31. 31.
    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 30:639–642PubMedCrossRefGoogle Scholar
  32. 32.
    Yamamoto K, Imakiire A, Shishido T et al (2003) Cementless total hip arthroplasty using porous-coated Biomet acetabular cups (Hexloc and Ringloc types). J Orthop Sci 8:657–663PubMedCrossRefGoogle Scholar
  33. 33.
    Pakvis D, van Hellemondt G, de Visser E et al (2011) Is there evidence for a superior method of socket fixation in hip arthroplasty? A systematic review. Int Orthop 35:1109–1118PubMedCrossRefGoogle Scholar
  34. 34.
    Clement ND, Biant LC, Breusch SJ (2012) Total hip arthroplasty: to cement or not to cement the acetabular socket? A critical review of the literature. Arch Orthop Trauma Surg 132:411–427PubMedCrossRefGoogle Scholar
  35. 35.
    Jacobs CA, Christensen CP, Greenwald AS et al (2007) Clinical performance of highly cross-linked polyethylenes in total hip arthroplasty. J Bone Joint Surg Am 89:2779–2786PubMedCrossRefGoogle Scholar
  36. 36.
    Mutimer J, Devane PA, Adams K et al (2010) Highly crosslinked polyethylene reduces wear in total hip arthroplasty at 5 years. Clin Orthop Relat Res 468:3228–3233PubMedCrossRefGoogle Scholar
  37. 37.
    Kurtz SM, Mazzucco D, Rimnac CM et al (2006) Anisotropy and oxidative resistance of highly crosslinked UHMWPE after deformation processing by solid-state ram extrusion. Biomaterials 27:24–34PubMedCrossRefGoogle Scholar
  38. 38.
    Oral E, Malhi AS, Wannomae KK et al (2008) Highly cross-linked ultrahigh molecular weight polyethylene with improved fatigue resistance for total joint arthroplasty: recipient of the 2006 Hap Paul Award. J Arthroplasty 23:1037–1044PubMedCrossRefGoogle Scholar
  39. 39.
    McCalden RW, Naudie DD, Yuan X et al (2005) Radiographic methods for the assessment of polyethylene wear after total hip arthroplasty. J Bone Joint Surg Am 87:2323–2334PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Hugo C. van der Veen
    • 1
    Email author
  • Hans-Peter W. van Jonbergen
    • 2
  • Rudolf W. Poolman
    • 3
  • Sjoerd K. Bulstra
    • 4
  • Jos J. A. M. van Raay
    • 1
  1. 1.Department of Orthopaedic SurgeryMartini HospitalGroningenThe Netherlands
  2. 2.Department of Orthopaedic SurgeryDeventer HospitalDeventerThe Netherlands
  3. 3.Department of Orthopaedic SurgeryOnze Lieve Vrouwe GasthuisAmsterdamThe Netherlands
  4. 4.Department of Orthopaedic SurgeryUniversity Medical Center GroningenGroningenThe Netherlands

Personalised recommendations