Wear of a highly cross-linked polyethylene liner: a preliminary RSA study
- 172 Downloads
Wear induced peri-prosthetic osteolysis and aseptic loosening remain the major contributing factors to failure of total hip arthroplasty. To reduce wear particles from acetabular liners, the process of polyethylene cross-linking has been modified. In this study, we examine the wear of Marathon™ acetabular liners using Radiostereometric Analysis. Thirty patients were enrolled in a prospective cohort study. Femoral head penetration was calculated for 25 patients at 6 months, 1 and 2 years postoperatively. The mean proximal head penetration was 0.067 mm at 6 months, 0.113 mm at 1 year and 0.120 mm at 2 years. The mean three-dimensional femoral head penetration was 0.240 mm at 6 months, 0.230 mm at 1 year and 0.232 mm at 2 years. For both parameters, there was no measurable wear between 1 and 2 years, and the mean annual linear wear was less than 0.06 mm/year, which is less than the suggested osteolysis threshold for polyethylene. All patients demonstrated a dramatic improvement in clinical scores. These results were comparable with other studies that used alternative techniques with conventional radiography to evaluate wear for Marathon™. Long-term studies using the RSA method are recommended to further quantify the clinical performance of this polyethylene liner.
KeywordsHip Wear RSA Polyethylene Radiostereometric analysis Cross-linked
The authors wish to thank Frankie Clark for her assistance with collection of patient data in this study. The authors wish to thank Alexandra Pearce for her assistance with preparation of the manuscript.
- 5.Schmalzried TP, Kwong LM, Jasty M, Sedlacek RC, Haire TC, O’Connor DO, Bragdon CR, Kabo JM, Malcolm AJ, Harris WH (1992) The mechanism of loosening of cemented acetabular components in total hip arthroplasty. Analysis of specimens retrieved at autopsy. Clin Orthop Relat Res 274:60–78PubMedGoogle Scholar
- 6.Australian Orthopaedic Association National Joint Replacement Registry (2007) Annual Report. Adelaide, AOA, pp 1–223Google Scholar
- 18.von Schewelov T, Onsten I, Markusson P, Carlsson A (2006) Weight bearing radiographs are not necessary for measurement of polyethylene penetration in total hip prostheses: a radiostereometric study of 111 patients examined in weight-bearing and supine position. Acta Orthop 77:104–108CrossRefGoogle Scholar
- 33.Engh CA Jr, Stepniewski AS, Ginn SD, Beykirch SE, Sychterz-Terefenko CJ, Hopper RH Jr, Engh CA (2006) A randomized prospective evaluation of outcomes after total hip arthroplasty using cross-linked marathon and non-cross-linked Enduron polyethylene liners. J Arthroplasty 21(Suppl 2):17–25PubMedGoogle Scholar
- 34.Glyn-Jones S, Isaac S, Hauptfleisch J, McLardy-Smith P, Murray DW, Gill HS (2008) Does highly cross-linked polyethylene wear less than conventional polyethylene in total hip arthroplasty? A double-blind, randomized, and controlled trial using roentgen stereophotogrammetric analysis. J Arthroplasty 23:337–343CrossRefPubMedGoogle Scholar
- 35.Bragdon CR, Malchau H, Yuan X, Perinchief R, Kärrholm J, Börlin N, Estok DM, Harris WH (2002) Experimental assessment of precision and accuracy of radiostereometric analysis for the determination of polyethylene wear in a total hip replacement model. J Orthop Res 20:688–695CrossRefPubMedGoogle Scholar