Cementless Acetabular Replacement in the Young

Dunkley, A. B.; Eldridge, Jonathan; Lee, Maureen B.; Smith, Ella Thea; Learmonth, Ian D.

doi:10.1097/00003086-200007000-00021

Cited by 44 publications

(14 citation statements)

References 27 publications

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“…Berger et al [1] reported polyethylene wear rate is related to the patient's age when using ultrahigh-molecular-weight polyethylene. In the series published by Dunkley et al [16] for patients 50 years or younger followed for a mean 7 years, six of 55 polyethylene liners were revised for excessive wear and an additional four liners had an eccentric wear pattern that was evident on radiographs. This increased wear rate in young patients also was reported by Dowdy and colleagues who described a 60% (12 of 20) incidence of considerable polyethylene wear and osteolysis in patients younger than 50 years [15].…”

Section: Discussionmentioning

confidence: 99%

THA with Highly Cross-linked Polyethylene in Patients 50 Years or Younger

Shia¹,

Clohisy²,

Schinsky³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Highly cross-linked polyethylene has been associated with low in vitro wear, but also has decreased in vitro ultimate yield strength. We therefore asked whether highly cross-linked polyethylene would result in lower outcome scores, wear, or early failure in a young patient population. Seventy THAs in 64 patients were performed using a highly cross-linked (electron beam-irradiated to 9 Mrads) acetabular liner and a cobalt-chrome femoral head. The average age of the patients at surgery was 41 years (range, 19-50 years). The minimum followup was 2.4 years (average, 4 years; range, 2.4-6.5 years). We recorded demographic and clinical data, including Harris hip score. Polyethylene wear measurements were analyzed with a validated, computer-assisted, edge detection method. The average Harris hip score improved from 53 to 92 at last followup. There was no evidence of acetabular or femoral loss of fixation, subsidence, or loosening. Linear wear was undetectable at this followup interval. No patient experienced catastrophic failure or underwent revision surgery. These data show low polyethylene wear rates and no catastrophic failures at early followup in a young patient cohort.

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Section: Discussionmentioning

confidence: 99%

THA with Highly Cross-linked Polyethylene in Patients 50 Years or Younger

Shia¹,

Clohisy²,

Schinsky³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…Pain was a symptom of late migration, not osteolysis. Dunkley et al (2000) reported 11% revisions for excessive wear of porous-coated metal-backed acetabular cups, but no cases of acetabular osteolysis in 55 hips with an average age of 41 years. In my series, the wear of the cup indicates risk of osteolysis.…”

Section: Discussionmentioning

confidence: 99%

High osteolysis and revision rate with the hydroxyapatite-coated ABG hip prostheses65 hips in 56 young patients followed for 5–9 years

Blacha

2004

Acta Orthopaedica Scandinavica

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Background There are few reports on the outcome of uncemented HA-coated cups in young patients.Patients I evaluated the 7-year (5-9) results of HAcoated hip prosthesis (ABG, Stryker) in a consecutive series of 65 primary arthroplasties on 56 patients (mean age 44 years). 2 patients were lost to follow-up and 3 died.Results The cumulative survival rate with revision for any reason as endpoint at 9 years was 98% (95% CI, 96-100) for the stem, 69% (61-77) for the acetabular metal backing, and 59% (50-67) for the polyethylene liner. 15 of 65 cups were revised on average 6 years after the primary operation and 3 more are planned. Revisions were done in 3 hips because of loosening and migration of the cup, and in 12 hips because of wear and progressive osteolysis around stable components. Only hips with migration had clinical symptoms. Visual inspection of polyethylene liners revealed wear of the articulation in all cases, loosening of the locking mechanism in 10 cases and nonarticular surface deformity in 7 hips. All original stems are in situ although femoral osteolysis was seen in 12 cases and 1 hip was reoperated because of periprosthetic traumatic fracture. Despite the high revision rate, the clinical improvement was good: the average pre-and postoperative Harris Hip Scores at the most recent follow-up were 41 and 90, respectively.Interpretation While the results on the femoral side were good, the survival rates of the acetabular cups were poor and we stopped using ABG I hip prostheses.

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“…12,[30][31][32] The clinical results of the hybrid THAs are comparable with those of other medium-term reports in young patients. 5,[33][34][35][36][37][38][39] However, polyethylene wear and osteolysis are a cause for concern. This review confirmed our previous observation 15 that a third of these patients refused to moderate activity likely to increase wear.…”

Section: Fig 8bmentioning

confidence: 99%

Treatment of the young active patient with osteoarthritis of the hip

Pollard

Baker

Eastaugh-Waring

et al. 2006

The Journal of Bone and Joint Surgery. British volume

210

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We compared the five- to seven-year clinical and radiological results of the metal-on-metal Birmingham hip resurfacing with a hybrid total hip arthroplasty in two groups of 54 hips, matched for gender, age, body mass index and activity level. Function was excellent in both groups, as measured by the Oxford hip score, but the Birmingham hip resurfacings had higher University of California at Los Angeles activity scores and better EuroQol quality of life scores. The total hip arthroplasties had a revision or intention-to-revise rate of 8%, and the Birmingham hip resurfacings of 6%. Both groups demonstrated impending failure on surrogate end-points. Of the total hip arthroplasties, 12% had polyethylene wear and osteolysis under observation, and 8% of Birmingham hip resurfacings showed migration of the femoral component. Polyethylene wear was present in 48% of the hybrid hips without osteolysis. Of the femoral components in the Birmingham hip resurfacing group which had not migrated, 66% had radiological changes of unknown significance.

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Cementless Acetabular Replacement in the Young

Cited by 44 publications

References 27 publications

THA with Highly Cross-linked Polyethylene in Patients 50 Years or Younger

THA with Highly Cross-linked Polyethylene in Patients 50 Years or Younger

High osteolysis and revision rate with the hydroxyapatite-coated ABG hip prostheses65 hips in 56 young patients followed for 5–9 years

Treatment of the young active patient with osteoarthritis of the hip

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