Highly cross-linked polyethylene still outperforms conventional polyethylene in THA: 10-year RSA results

Bergvinsson, Halldor; Zampelis, Vasilis; Sundberg, Martin; Flivik, Gunnar

doi:10.1080/17453674.2021.1932140

Cited by 12 publications

(5 citation statements)

References 27 publications

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“… 21 22 23 24) Mid- to long-term studies of THAs using these bearings showed over 95% survival rates and excellent functional outcomes. 21 22 25 26 27) In our study, the proportion of joint preservation procedures decreased by more than 50% during the study period.…”

Section: Discussionsupporting

confidence: 43%

Trends in Surgical Treatment of Femoral Head Osteonecrosis in South Korea: An Analysis Using Nationwide Claims Database

Park

Kim

Park³

et al. 2022

Clin Orthop Surg

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Background Osteonecrosis of the femoral head (ONFH) involves young or middle-aged adults, and its incidence is increasing along with increasing use of steroids in the management of organ transplantation and adjuvant therapy for malignant neoplasms. To date, no pharmacological agent has been proven to prevent or retard the progression of ONFH, and surgical procedures including joint preservation procedures and hip arthroplasties are main treatments for the disease. Although ONFH is the most common or second most common disease for hip arthroplasty in East Asian countries, the trend of surgical procedures in this region remains unknown. Thus, we evaluated trends in surgical treatment of the disease in South Korea. Methods We identified patients with ONFH from the Korean Health Insurance Review and Assessment (HIRA) database, a nationwide medical claims database of South Korea, between January 2007 and December 2018 and calculated the proportions of following surgical procedures at each year: total hip arthroplasty (THA), hemiarthroplasty (HA), core decompression/multiple drilling, femoral osteotomy, and vascularized bone grafting. Results The total number of procedures increased from 3,824 in 2007 to 6,929 in 2018. Overall, the rate of THA (86%) was far greater than other procedures. From 2007 to 2018, the percentage of THA among the procedures increased from 80% to 91%, while that of joint preservation procedures decreased from 11% to 5%. Conclusions The total number of surgical procedures performed for ONFH increased and the percentage of THA increased, while that of joint preservation procedures decreased from 2007 to 2018 in South Korea.

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Section: Discussionsupporting

confidence: 43%

Trends in Surgical Treatment of Femoral Head Osteonecrosis in South Korea: An Analysis Using Nationwide Claims Database

Park

Kim

Park³

et al. 2022

Clin Orthop Surg

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“… 1 , 19 , 26 , 27 Only one RSA study of larger articulations reported a median proximal wear rate of 0.002 mm/year for 36 mm articulations, 19 which is similar to our findings. One long-term RSA study did report a proximal wear rate of 0.020 mm/year, 28 but did not exclude bedding-in between three months and one year. The exclusion of bedding-in within the first year is known to be an important methodological consideration, 21 as more recently highlighted by Khosbin et al 2 Bedding-in likely contributed to considerably larger 3D wear rates of 0.066, 29 0.067, 30 0.055, 31 and 0.042mm/year, respectively, 32 being reported in long-term studies of XLPE liners that used a unique retrospective RSA methodology with no baseline examination.…”

Section: Discussionmentioning

confidence: 99%

Large articulations do not increase wear rates of thin second-generation highly cross-linked polyethylene liners at ten years

Callary,

Sharma,

D’Apollonio

et al. 2023

Bone Jt Open

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AimsRadiostereometric analysis (RSA) is the most accurate radiological method to measure in vivo wear of highly cross-linked polyethylene (XLPE) acetabular components. We have previously reported very low wear rates for a sequentially irradiated and annealed X3 XLPE liner (Stryker Orthopaedics, USA) when used in conjunction with a 32 mm femoral heads at ten-year follow-up. Only two studies have reported the long-term wear rate of X3 liners used in conjunction with larger heads using plain radiographs which have poor sensitivity. The aim of this study was to measure the ten-year wear of thin X3 XLPE liners against larger 36 or 40 mm articulations with RSA.MethodsWe prospectively reviewed 19 patients who underwent primary cementless THA with the XLPE acetabular liner (X3) and a 36 or 40 mm femoral head with a resultant liner thickness of at least 5.8 mm. RSA radiographs at one week, six months, and one, two, five, and ten years postoperatively and femoral head penetration within the acetabular component were measured with UmRSA software. Of the initial 19 patients, 12 were available at the ten-year time point.ResultsThe median proximal, 2D, and 3D wear rates calculated between one and ten years were all less than 0.005 mm/year, with no patient recording a proximal wear rate of more than 0.021 mm/year. Importantly, there was no increase in the wear rate between five and ten years.ConclusionThe very low wear rate of X3 XLPE liners with larger articulations remains encouraging for the future clinical performance of this material.Cite this article: Bone Jt Open 2023;4(11):839–845.

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“…In this study, BM was not associated with higher wear, likely because it is a thin coating and quickly resorbed. Bergvinsson et al reported RSA measured wear rates (proximal wear) of 0.12 mm/year for UHMWPE and 0.02 mm/year for HXLPE in porous-coated cups considering a 3-month bedding-in period and 10 years’ follow-up ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Larger 5-year migration but similar polyethylene wear of cementless hemispherical cups with electrochemically applied hydroxyapatite (BoneMaster) coating compared with porous plasma-spray titanium: a randomized 5-year RSA study

Mosegaard

Jørgensen

Jakobsen

et al. 2022

ActaO

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Background and purpose: BoneMaster (BM) is a thin electrochemically applied hydroxyapatite (HA) implant coating marketed with expectations of improved osseointegration properties but less polyethylene (PE) wear. We compared the midterm cup migration and PE wear of cementless porous-coated hemispherical cups with and without BM.Patients and methods: In this patient-blinded, randomized controlled trial, 53 patients with a mean age of 64 years (55–75) received total hip arthroplasty with a porous-coated (P) or porous and BoneMaster (PBM) coated Exceed cup and ArCom E1 infused PE. Patients were followed with RSA, Hip Osteoarthritis Outcome Score (HOOS), and Euro-Qol-5-3L (EQ-5D) at 3 and 6 months, and 1-, 2-, and 5-yearfollow-up.Results: At 5-year follow-up, total translation and maximum total point motion was 0.28 mm (95% CI 0.08; 0.47) and 0.52 mm (CI 0.12; 0.93) higher in the PBM group than in the P group. PE wear was comparable between PBM and P cups, and 2D wear rate from 1-year follow-up to last follow-up was 0.03 mm (CI 0.02–0.03). The 5-year anterior translation was 0.05 mm (CI –0.10 to 0.21) in the normal BMD group and 0.40 mm (CI 0.22–0.57) in the osteopenia group.Interpretation: At 5-year follow-up, Exceed cups in the PBM group migrated more than in the P group but the PE wear rate was low and similar. This study does not indicate any advantage of additional BoneMaster coating compared with porous coating alone on cementless hemispherical cups with regards to migration, polyethylene wear, and clinical outcomes.

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Highly cross-linked polyethylene still outperforms conventional polyethylene in THA: 10-year RSA results

Cited by 12 publications

References 27 publications

Trends in Surgical Treatment of Femoral Head Osteonecrosis in South Korea: An Analysis Using Nationwide Claims Database

Trends in Surgical Treatment of Femoral Head Osteonecrosis in South Korea: An Analysis Using Nationwide Claims Database

Large articulations do not increase wear rates of thin second-generation highly cross-linked polyethylene liners at ten years

Larger 5-year migration but similar polyethylene wear of cementless hemispherical cups with electrochemically applied hydroxyapatite (BoneMaster) coating compared with porous plasma-spray titanium: a randomized 5-year RSA study

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