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Femoral Head Size and Wear of Highly Cross-linked Polyethylene at 5 to 8 Years

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Wear of highly cross-linked polyethylene is reportedly independent of head size. To confirm that observation we asked in our population whether head size related to wear with one type of electron beam highly cross-linked polyethylene. Of 146 hips implanted, we evaluated complete clinical and radiographic data for 90 patients (102 hips or 70%). The minimum followup was 5 years (mean, 5.7 years; range, 5–8 years). The head size was selected intraoperatively based on the size of the acetabular component and presumed risk of dislocation. Polyethylene wear measurements were performed in one experienced laboratory using the method of Martell et al. There was no hip with pelvic or femoral osteolysis. The median linear wear rate was 0.028 mm/year (mean, 0.04 mm/year), and the median volumetric wear rate was 25.6 mm3/year (mean, 80.5 mm3/year). Median total volumetric wear was 41.0 mm3 (mean, 98.5 mm3). We found no association between femoral head size and the linear wear rate, but observed an association between larger (36- and 40-mm) head size and volumetric wear rate and total volumetric wear. Although the linear wear rate of polyethylene was not related to femoral head diameter, there was greater volumetric wear (156.6 mm3/year) with the 36- and 40-mm heads. Pending long-term studies of large head sizes, we advise caution in using larger femoral heads in young or active patients and in those with a low risk of dislocation.

Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Darlene M. Urlaub for assistance in this investigation and Stephen W Marshall, PhD, for assistance with statistical analysis.

Author information

Authors and Affiliations

  1. Chapel Hill Orthopedic Surgery & Sports Medicine, 101 Conner Drive, Suite 200, Chapel Hill, NC, 27514, USA

    Paul F. Lachiewicz MD & Elizabeth S. Soileau BSN

  2. Department of Orthopaedics, University of North Carolina, 3151 Bioinformatics Building, CB 7055, Chapel Hill, NC, 27514, USA

    Daniel S. Heckman MD

  3. Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago Medical Center, Chicago, IL, USA

    Jimmi Mangla MD & John M. Martell MD

Authors
  1. Paul F. Lachiewicz MD
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  2. Daniel S. Heckman MD
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  3. Elizabeth S. Soileau BSN
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  4. Jimmi Mangla MD
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  5. John M. Martell MD
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Corresponding author

Correspondence to Paul F. Lachiewicz MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at the University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, and the University of Chicago Medical Center, Chicago, IL, USA.

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Lachiewicz, P.F., Heckman, D.S., Soileau, E.S. et al. Femoral Head Size and Wear of Highly Cross-linked Polyethylene at 5 to 8 Years. Clin Orthop Relat Res 467, 3290–3296 (2009). https://doi.org/10.1007/s11999-009-1038-9

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  • DOI: https://doi.org/10.1007/s11999-009-1038-9

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