Damage of Oxinium Femoral Heads Subsequent to Hip Arthroplasty Dislocation

Kop, Alan; Whitewood, Colin; Johnston, Don J.L.

doi:10.1016/j.arth.2006.07.005

Cited by 84 publications

(52 citation statements)

References 7 publications

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“…Oxinium with its enhanced surface wear properties but without risk of fracture was subsequently used for our patients' femoral articulation. More recent reports have documented damage to the Oxinium surface, which is of concern to surgeons and patients because of the potential for increased wear of the HXLPE [13,16,20,27,33]. The problem is of particular importance to those patients who sustain a prosthetic dislocation [13,16,20,27].…”

Section: Discussionmentioning

confidence: 99%

“…Initially, this was ceramic but because of the risk of fracture and the in vitro results of Oxinium (Smith & Nephew, Memphis, TN, USA), we transitioned to Oxinium for these patients. Recent reports of surface damage to Oxinium and the potential for accelerated wear of HXLPE because of the surface damage led us to perform this investigation in our patients 50 years or younger at a minimum 9-year followup [13,16,20,27,33]. We asked two questions.…”

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confidence: 99%

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Low Wear Rates Seen in THAs With Highly Crosslinked Polyethylene at 9 to 14 Years in Patients Younger Than Age 50 Years

Garvin

White

Dusad

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Patients 50 years or younger are at high risk for wear-related complications of their total hip arthroplasty (THA) because of their generally higher levels of activity. Highly crosslinked polyethylene (HXLPE) is believed to be more durable for this population than conventional polyethylene because of its improved wear; however, limited information is available on the wear of HXLPE in this population, particularly the wear of HXLPE when it articulates with alternative bearings like Oxinium (Smith & Nephew, Memphis, TN, USA).Questions/purposes The purpose of this study was to evaluate two questions relative to this population of patients undergoing THA. First, what was the linear and volumetric wear rate of HXLPE in patients 50 years or younger at a minimum followup of 9 years and was osteolysis observed in any of these hips? Given the potential for damage to the Oxinium femoral head surface, was the wear of HXLPE in the patients with this material similar to the other bearings or was there accelerated or runaway wear that was visible in any of the patients? Methods From November 1999 to April 2005, 105 THAs were performed in 95 patients 50 years of age or younger (mean, 42 years; range, 20-50 years). The mean body mass index was 30 kg/m 2 (range, 17-51 kg/m 2 ).The mean followup was 12 years (range, 9-14 years). Two patients died, five patients (one bilateral) were lost to followup, and one hip was revised elsewhere for pain. The patients' information was not included in the study, which left 87 patients with 96 hips for analysis. Highly crosslinked polyethylene was the acetabular bearing for all of the hips. We analyzed the linear and volumetric wear of all of the hips using the Martell method. Eighty hips had the same diameter head (28 mm) allowing us to more accurately compare the different bearing materials. The type of femoral head used was related to our sequential use of materials beginning with cobalt chrome (14), ceramic (23) followed by Oxinium (43) in the hips with 28-mm heads. Although cobalt-chrome was used early in this study, our previous experience with ceramic on polyethylene encouraged us to use it as an alternative bearing. The Oxinium was used consecutively for the remaining hips. Results The mean wear of the HXLPE after 1 year of bedding-in (true linear wear)was 0.022 mm/year (95% confidence interval [CI], 0.015-0.030 mm/year). The mean volumetric wear of HXLPE after 1 year of bedding-in (true volumetric wear) was 9 mm 3 /year (95% CI, 4-14 mm 3

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Low Wear Rates Seen in THAs With Highly Crosslinked Polyethylene at 9 to 14 Years in Patients Younger Than Age 50 Years

Garvin

White

Dusad

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…Kop et al [11] compared indentation damage of oxidized zirconium and cobalt-chrome femoral heads in vitro by pivoting on the edge of an acetabular shell rim. The oxidized zirconium head indentations were 54% deeper than the cobalt-chrome heads.…”

Section: Discussionmentioning

confidence: 99%

“…In vivo studies of femoral head damage are case reports describing a total of four head retrievals secondary to dislocation. The authors reported substantial damage to the heads thought to have occurred at the time of dislocation or attempted closed reduction [4,11]. The case reports of retrieval specimens give cause for concern.…”

Section: Discussionmentioning

confidence: 99%

Wear Analysis in THA Utilizing Oxidized Zirconium and Crosslinked Polyethylene

Garvin¹,

Hartman²,

Mangla³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Oxidized zirconium, a material with a ceramic surface on a metal substrate, and highly cross-linked polyethylene are two materials developed to reduce wear. We measured in vivo femoral head penetration in patients with these advanced bearings. We hypothesized the linear wear rates would be lower than those published for cobaltchrome and standard polyethylene. We retrospectively reviewed a select series of 56 THAs in a relatively young, active patient population utilizing oxidized zirconium femoral heads and highly cross-linked polyethylene acetabular liners. Femoral head penetration was determined using the Martell computerized edge-detection method. All patients were available for 2-year clinical and radiographic followup. True linear wear was 4 lm/year (95% confidence intervals, ± 59 lm/year). The early wear rates in this cohort of relatively young, active patients were low and we believe justify the continued study of these alternative bearing surfaces.

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“…3 We report a case of an Oxinium™ femoral head undergoing advanced in situ wear and discuss the probable failure mechanism.…”

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confidence: 99%

Advanced wear of an Oxinium™ femoral head implant following polyethylene liner dislocation

Tribe

Malek

Stammers

et al. 2013

Ann R Coll Surg Engl

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Oxinium™ (Smith & Nephew, Memphis, TN, US) has been used in hip arthroplasty since 2003. The surface coating is hard and provides low wear rates but if this surface coating is damaged, the soft metal core is at risk of accelerated wear. Previous reports have described accelerated wear following intra and postoperative hip dislocation. We report a case of advanced wear of an in situ Oxinium™ femoral head implant following a cracked acetabular liner. The liner had disengaged from the titanium shell, allowing the Oxinium™ head to articulate directly with the shell. The disengaged liner led to dislocation of the Oxinium™ head, with associated pronounced wear of the head and the acetabular cup. The patient had a successful revision procedure. We advise close follow-up of patients with Oxinium™ implants, especially if associated with dislocation and closed reduction.A low wear rate is a key element of long-term total hip arthroplasty survival. Ceramic femoral heads have lower wear rates than traditional cobalt-chrome when articulated with a polyethelene acetabular liner but ceramic material is brittle and fracture is a reported failure mechanism.

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Damage of Oxinium Femoral Heads Subsequent to Hip Arthroplasty Dislocation

Cited by 84 publications

References 7 publications

Low Wear Rates Seen in THAs With Highly Crosslinked Polyethylene at 9 to 14 Years in Patients Younger Than Age 50 Years

Low Wear Rates Seen in THAs With Highly Crosslinked Polyethylene at 9 to 14 Years in Patients Younger Than Age 50 Years

Wear Analysis in THA Utilizing Oxidized Zirconium and Crosslinked Polyethylene

Advanced wear of an Oxinium™ femoral head implant following polyethylene liner dislocation

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