Wear Analysis of Highly Cross-Linked Polyethylene in Total Hip Arthroplasty
Three hundred and eighty-five primary THAs (355 patients) in which HXLPE liners (Longevity or Durasul, Zimmer Inc.) with either 22, 26, 28 or 32 mm femoral heads were implanted between January 1, 1999 and December 31, 2002. The clinical measures used to evaluate these patients are the Harris hip, EQ-5D, and UCLA activity scores. In addition to conventional plain radiograph assessment, the Martell method was used to measure head penetration over time. A matched set of 186 THAs (129 patients) with 26 and 28 mm head sizes coupled with conventional gamma sterilized in air polyethylene with a minimum of 7 years follow-up was identified as a wear measurement control group.
No components show radiographic loosening, failure or fracture. There are no osteolytic lesions around the cup or stem. No revisions have been performed for polyethylene wear or liner fracture. The average scores (±StDev) for the Harris hip, EQ-5D, and UCLA activity surveys were 86.91 ± 15.61, 80.01 ± 16.81, 6.13 ± 2.06 respectively. Based on the longest follow-up film of individuals with a minimum 7 year follow-up, the average head penetration rates were 7.2 ± 78.0 and 4.3 ± 87.3 mm/year for 28 and 32 mm heads respectively. There was no significant difference in the head penetration rates between the 28 and 32 mm heads. This average wear rate was significantly different than that of a match set of conventional PE liners coupled with 26 and 38 mm heads (97 ± 140.7 mm/year, p < 0.0001).
KeywordsFemoral Head Femoral Head Size Head Penetration Diameter Femoral Head Conventional Polyethylene
Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.
- 2.Jasty, M., Haire, T., Tanzer, M.: Femoral osteolysis: a generic problem with cementless and cemented femoral components. Orthop. Trans. 15, 758–759 (1991)Google Scholar
- 3.Jasty, M., et al.: Endosteal osteolysis around well-fixed porous-coated cementless femoral components. In: St. John, K.R. (ed.) Particulate Debris from Medical Implants. ASTM STP 1144, Philadelphia (1992)Google Scholar
- 7.Manley, T.R., Qayyum, M.M.: Crosslinked polyethylene at elevated temperatures. Polymer 12, 177–181 (1971)Google Scholar
- 8.Jacobs, C.A., Christensen, C.P., Greenwald, A.S., McKellop, H.: Clinical performance of highly cross-linked polyethylenes in total hip arthroplasty. J Bone Joint Surg Am. 89(12), 2779–2786 (2007)Google Scholar
- 9.Muratoglu, O.K., et al.: A comparison of five different types of highly crosslinked UHMWPEs: physical properties and wear behavior. In: Annual Meeting of Orthopaedic Research Society, Anaheim (1999)Google Scholar
- 10.Narkis, M., et al.: Structure and tensile behavior of irradiation- and peroxide-crosslinked polyethylenes. J. Macromol. Sci. B26(1), 37–58 (1987)Google Scholar
- 12.Bragdon, C.R., O’Connor, D.O., Lowenstein, J.D., Jasty, M., Biggs, S.A., Harris, W.H.: A new pin-on-disk wear testing method for simulating wear of polyethylene on cobalt-chrome alloy in total hip arthroplasty. J Arthroplasty. 16(5), 658–665 (2001)Google Scholar
- 18.Muratoglu, O., et al.: A Highly crosslinked, melted UHMWPE: expanded potential for total joint arthroplasty. In: Rieker, C., Oberholzer, S., Wyss, U. (eds.) World Tribology Forum in Arthroplasty, pp. 245–262. Hans Huber, Bern (2001)Google Scholar
- 28.Karrholm, J., et al.: Five to 7 years experiences with highly cross-linked PE. In: SICOT TWC Abstract #19059. Hong Kong http://www.sicot.org/. 2008
- 29.Martell, J., et al.: Results of primary total hip reconstruction with the cementless Harris-Galante prosthesis: minimum five year results. Orthop. Trans. 15, 750 (1991)Google Scholar
- 31.Bragdon, C.R., et al.: A five year clinical comparison of the measurement of femoral head penetration in THR using RSA and the Martell method. In: 50th Annual Meeting Orthopaedic Research Society, San Francisco, (2004)Google Scholar
- 33.Greene, M.E., et al.: A comparison of the Devane and Martell methods for in vivo measurement of polyethylene wear of patients with highly cross-linked polyethylene THR components. In: 54th Annual Meeting of the Orthopaedic Research Society, San Francisco (2008)Google Scholar
- 42.Muratoglu, O.K., et al.: Identification and quantification of radiation in UHMWPE. In: Annual Meeting of Orthopaedic Research Society, Anaheim (1999)Google Scholar
- 43.Muratoglu, O.K., et al.: Electron beam crosslinking of UHMWPE at room temperature, a candidate bearing material for total joint arthroplasty. In: 23rd Annual Meeting of the Society for Biomaterials, New Orleans (1997)Google Scholar