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Clinical Orthopaedics and Related Research®

, Volume 469, Issue 2, pp 372–381 | Cite as

The Incidence of Acetabular Osteolysis in Young Patients With Conventional versus Highly Crosslinked Polyethylene

  • Nathan A. Mall
  • Ryan M. Nunley
  • Jin Jun Zhu
  • William J. Maloney
  • Robert L. Barrack
  • John C. ClohisyEmail author
Symposium: Papers Presented at the Hip Society Meetings 2010

Abstract

Background

Osteolysis is a major mode of hip implant failure. Previous literature has focused on the amount of polyethylene wear comparing highly crosslinked polyethylene (HXPLE) with conventional liners but has not clarified the relative incidence of osteolysis with these two liners.

Questions/purposes

We determined (1) the incidence of osteolysis in HXLPE versus conventional polyethylene (CPE), (2) the ability to detect and evaluate the size of lytic lesions using radiographs compared with CT scans, (3) head penetration in hips without and with lysis, and (4) determined whether acetabular position, head size, and UCLA activity score contributed to lysis.

Methods

We compared head penetration and osteolysis on plain radiographs and presence and volume of osteolysis on CT scans in 48 patients with HXLPE (mean, 46.5 years) and 50 patients with CPE (mean, 43.2 years). The minimum followup was 5 years (average, 7.2 years; range, 5.1–10.9 years),

Results

Osteolysis was apparent on CT in a larger number of patients with CPE liners than HXLPE liners: 12 of 50 (24%) versus one of 48 (2%), respectively. We found no correlation between head penetration and volume of osteolytic lesions. Head penetration was greater in patients with osteolysis. Smaller head sizes were associated with greater wear and those with osteolysis had smaller head sizes; however, there was no difference in acetabular component position or UCLA activity in those with lysis compared with those without.

Conclusions

HXLPE diminished the incidence of osteolysis, but the lack of correlation between penetration and volume of osteolysis suggests other factors other than wear contribute to the development of osteolysis.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Keywords

Acetabular Component Osteolytic Lesion Head Size Lytic Lesion Acetabular Anteversion 
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 Kirk E. Smith for his work with CT scan processing and measurement of these CT examinations.

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Copyright information

© The Association of Bone and Joint Surgeons® 2010

Authors and Affiliations

  • Nathan A. Mall
    • 1
  • Ryan M. Nunley
    • 1
  • Jin Jun Zhu
    • 1
  • William J. Maloney
    • 2
  • Robert L. Barrack
    • 1
  • John C. Clohisy
    • 1
    Email author
  1. 1.Department of OrthopedicsWashington University School of Medicine, Barnes-Jewish HospitalSt LouisUSA
  2. 2.Department of Orthopaedic SurgeryStanford University School of MedicineStanfordUSA

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