Highly Crosslinked Polyethylene Reduces Wear in Total Hip Arthroplasty at 5 Years

Mutimer, J; Devane, P.; Adams, Kathryn Betts; Horne, J. G.

doi:10.1007/s11999-010-1379-4

Cited by 85 publications

(58 citation statements)

References 27 publications

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“…This is likely attributable to the superior accuracy and precision of the RSA method. The 2-D wear rate observed in our study was more than three times less than that reported by Mutimer et al [24]. Possible explanations for the larger wear rate reported is that the patient cohorts may have been different, and the wear was calculated after 6 months which may have been insufficient to account for all of the creep and bedding-in.…”

Section: Discussioncontrasting

confidence: 73%

“…Five recent studies [1,11,12,20,24] measured femoral head penetration of the Marathon TM polyethylene liner, with at least 5 years of followup using computer-based analyses of plain radiographs ( Table 2). The 2-D wear rate measured in our study, 0.014 mm/year, was at the lower end of these varying reports and with a smaller range of results.…”

Section: Discussionmentioning

confidence: 99%

“…The precision (95% CI) of the RSA method for this cohort was 0.033, 0.019, and 0.072 mm for medial, proximal, and anterior wear respectively [5]. Recently, the amount of wear for the same liner has been measured in five prospective studies over five years using the computer-based methods, Polyware Auto [24], Martell's Hip Analysis Suite [1,11,12], and AutoCAD 1 (Autodesk 1 , San Rafael, CA, USA) [20]. These five studies reported varying mean 2-D wear rates of 0.01 [12], 0.031 [1], 0.04 [11], 0.05 [24], and a 2-D penetration rate of 0.06 mm/year [20].…”

Section: Introductionmentioning

confidence: 86%

“…Recently, the amount of wear for the same liner has been measured in five prospective studies over five years using the computer-based methods, Polyware Auto [24], Martell's Hip Analysis Suite [1,11,12], and AutoCAD 1 (Autodesk 1 , San Rafael, CA, USA) [20]. These five studies reported varying mean 2-D wear rates of 0.01 [12], 0.031 [1], 0.04 [11], 0.05 [24], and a 2-D penetration rate of 0.06 mm/year [20]. Given the excellent precision of RSA, and the variability of these findings, we sought to measure the amount and direction of wear of the Marathon TM cross-linked polyethylene liner in a similar cohort at 6 years.…”

Section: Introductionmentioning

confidence: 99%

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Wear of a 5 Megarad Cross-linked Polyethylene Liner: A 6-year RSA Study

Callary

Campbell

Mercer

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background One cross-linked polyethylene (XLPE) liner is manufactured using a lower dose of radiation, 5 Mrad, which may result in less cross-linking. The reported in vivo wear rate of this XLPE liner in patients undergoing THA has varied, and has included some patients in each reported cohort who had greater than 0.1 mm/year of wear, which is an historical threshold for osteolysis. Previous studies have measured wear on plain radiographs, an approach that has limited sensitivity.Questions/purposes We therefore measured the amount and direction of wear at 6 years using Radiostereometric analysis (RSA) in patients who had THAs that included a cross-linked polyethylene liner manufactured using 5 Mrad radiation. Methods We prospectively reviewed wear in 30 patients who underwent primary THAs with the same design of cross-linked acetabular liner and a 28-mm articulation. Tantalum markers were inserted during surgery and all patients had RSA radiographic examinations at 1 week, 6 months, 1, 2, and 6 years postoperatively. Results The mean proximal, two-dimensional (2-D) and three-dimensional (3-D) wear rates calculated between 1 year and 6 years were 0.014, 0.014, and 0.018 mm/per year, respectively. The direction of the head penetration recorded between 1 week and 6 years was in a proximal direction for all patients, proximolateral for 16 of 24 patients, and proximomedial for eight of 24 patients. Conclusions The proximal, 2-D and 3-D wear of a XLPE liner produced using 5 Mrad of radiation was low but measurable by RSA after 6 years. No patients had proximal 2-D or 3-D wear rates exceeding 0.1 mm/year. Further followup is needed to evaluate the effect of XLPE wear particles on the development of long-term osteolysis.

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Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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Wear of a 5 Megarad Cross-linked Polyethylene Liner: A 6-year RSA Study

Callary

Campbell

Mercer

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…Highly crosslinked ultrahigh-molecular-weight polyethylene (XLPE) has demonstrated superior wear performance compared with conventional polyethylene (PE) in THA with followup studies beyond 10 years showing few or no patients with osteolysis [5,6,10,21,24,26,32]. XLPE was more recently introduced into TKA after in vitro knee simulator findings of lower wear rates compared with those found with conventional PE [12,22,33,34].…”

Section: Introductionmentioning

confidence: 99%

Surface Damage Is Not Reduced With Highly Crosslinked Polyethylene Tibial Inserts at Short-term

Liu

Esposito

Elpers

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Highly crosslinked ultrahigh-molecularweight polyethylene (XLPE) has been shown to reduce wear in hip arthroplasty, but the advantages over conventional polyethylene (PE) in total knee arthroplasty (TKA), if any, remain unclear. Questions/purposes Do differences exist in (1) surface damage as measured by damage score and percent area affected; and (2) extent and location of dimensional changes between XLPE and conventional PE observed on retrieved TKA tibial inserts?Methods In this study of components retrieved at the time of revision surgery, we matched 44 XLPE to 44 conventional PE inserts from four manufacturers; the matching approach considered implant design (exact match), insert size (exact match), and length of implantation (matched ± 6 months). Surface damage on the articular surfaces was subjectively graded and digitally mapped to determine the percent damaged area of each damage mode. Three-dimensional changes that had occurred as a result of implantation were determined by comparing laser scans of the retrieved inserts with size-matched pristine inserts. Results The differences of damage scores and percent damaged areas between the matched XLPE and conventional PE inserts were not large enough to be clinically significant with low corresponding levels of statistical significance (scores: 42 ± 13; 95% confidence interval [CI], 38-46 versus 45 ± 13; 95% CI, 41-49; p = 0.4; percent areas: 54% ± 38%; 95% CI, 44%-64% versus 54% ± 32%; 95% CI, 42%-65%; p = 0.9). However, XLPE inserts showed greater articular surface dimensional changes with high significance (root mean square of the distance: 0.16 ± 0.06 mm; 95% CI, 0.13-0.18 mm versus 0.14 ± 0.05 mm; 95% CI, 0.11-0.16 mm; p = 0.03). Within the same design, deviation patterns were consistent between the two materials; however, as expected, the location of the dimensional changes differed among designs: the negative deviations on the plateaus were centrally located in Zimmer PS inserts, were located on the perimeter in Smith & Nephew PS inserts, and were across the entire surface in DePuy PS inserts.

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Arctigenin inhibits RANKL‐induced osteoclastogenesis and hydroxyapatite resorption in vitro and prevents titanium particle–induced bone loss in vivo

Wei

Liang

Wei

et al. 2018

J of Cellular Biochemistry

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Wear particle–induced bone resorption leads to prosthesis loosening, which is a major complication associated with total joint arthroplasty. Although the exact mechanism remains unclear, wear particle–induced extensive osteoclastogenesis plays a critical role in this process. Thus, a potential treatment of prosthetic loosening is focused on suppressing extensive osteoclast formation and bone resorption, which prevents wear particle–induced osteolysis. Arctigenin isolated from Arctium lappa has numerous beneficial pharmacologic effects, including anti‐inflammatory, antiviral, and anticancer activities. Here, we explored the potential impact of arctigenin on titanium (Ti) particle–induced osteolysis in vivo. Our data showed that arctigenin significantly suppressed Ti particle–induced osteolysis and prevented bone destruction compared with Ti group. In addition, the number of osteoclasts reduced after treatment with arctigenin in vivo, indicating osteoclastogenesis might be inhibited by arctigenin. Next, bone marrow–derived macrophages were used to examine osteoclast differentiation, bone resorption, and activation of osteoclast‐related signaling pathways. The results showed that arctigenin inhibited RANKL‐induced osteoclastogenesis without any cytotoxicity and suppressed osteoclastic marker genes expression and hydroxyapatite resorption activity in a dose‐dependent manner. Additionally, arctigenin suppressed receptor activator of nuclear factor κΒ (NF‐κB) ligand–induced NF‐κB activation, concomitant with retarded IκBɑ degradation and inhibition of p65 nuclear translocation, leading to impaired osteoclastogenesis. Collectively, our results suggest that arctigenin is a promising candidate for the treatment of osteoclast‐related osteolytic diseases caused by excessive osteoclast formation.

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Highly Crosslinked Polyethylene Reduces Wear in Total Hip Arthroplasty at 5 Years

Cited by 85 publications

References 27 publications

Wear of a 5 Megarad Cross-linked Polyethylene Liner: A 6-year RSA Study

Wear of a 5 Megarad Cross-linked Polyethylene Liner: A 6-year RSA Study

Surface Damage Is Not Reduced With Highly Crosslinked Polyethylene Tibial Inserts at Short-term

Arctigenin inhibits RANKL‐induced osteoclastogenesis and hydroxyapatite resorption in vitro and prevents titanium particle–induced bone loss in vivo

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