Less wear with aluminium-oxide heads than cobalt-chrome heads with ultra high molecular weight cemented polyethylene cups: A ten-year follow-up with radiostereometry

Dahl, Jon E.; Söderlund, Per; Nivbrant, Bo; Nordsletten, Lars; Röhrl, Stephan M

doi:10.1007/s00264-011-1334-3

Cited by 19 publications

(9 citation statements)

References 30 publications

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“…The finding of a higher risk for revision resulting from aseptic loosening with alumina heads than with CoCr heads is inconsistent with reports on higher survival for certain uncemented prosthesis brands with alumina compared with metal heads [13,17]. One radiostereometry study reported approximately 50% wear reduction with alumina heads compared with CoCr heads after 10 years followup of THAs with conventional PE cups [5]. The finding of increased revision resulting from aseptic loosening of THAs with alumina heads must be interpreted with caution because the number of THAs with alumina heads was relatively small, the difference in revision at 8 years was only 4%, the confidence intervals on the survival curves were overlapping, and the numbers of revised cups and stems in the alumina group were only 13 and 11, respectively.…”

Section: Discussioncontrasting

confidence: 47%

Head Material Influences Survival of a Cemented Total Hip Prosthesis in the Norwegian Arthroplasty Register

Kadar

Dybvik

Hallan

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background High prosthesis survival is reported for total hip prostheses with metal and alumina heads, but direct comparisons of a single prosthesis design with one of two different head materials has seldom been studied. Prostheses with zirconia heads are less commonly used than metal and alumina heads, and the few reports suggest variable results with zirconia heads.Questions/Purposes We therefore asked: (1) Would metal heads provide better survival of a cemented total hip arthroplasty (THA) than alumina heads? (2) Would metal heads provide better survival of a cemented THA than zirconia heads? Methods We searched in the Norwegian Arthroplasty Register for cemented primary THA cup/stem combinations that simultaneously had been used with different head materials. The only THA that fulfilled these inclusion criteria was the cemented Reflection All-Poly/ Spectron EF (cup/stem) that had during 2001 to 2006 been used both with alumina (n = 448) and cobaltchromium (n = 5229) heads; that implant had also been used with zirconia (n = 275) and cobalt-chromium heads (n = 3195) during 1997 to 2003, and we included patients with this THA from these two time intervals in the study. All cups were conventional polyethylene. We estimated prosthesis survival and relative revision risks adjusting for age, sex, and diagnosis. The followup in the two study materials was until December 2010.

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Section: Discussioncontrasting

confidence: 47%

Head Material Influences Survival of a Cemented Total Hip Prosthesis in the Norwegian Arthroplasty Register

Kadar

Dybvik

Hallan

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Other materials should be as safe and should have durability superior to that of metal heads, to replace them as the material of choice for use with PE in THR. One RSA study showed better wear properties for alumina heads than for cobalt-chrome heads with cemented cups (Dahl et al 2012). Another study showed the opposite with uncemented cups (Sychterz et al 2000).…”

mentioning

confidence: 99%

More than 50% reduction of wear in polyethylene liners with alumina heads compared to cobalt-chrome heads in hip replacements

et al. 2013

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Background and purposeExcessive wear of acetabular liners in hip replacements may lead to osteolysis and cup loosening. Different head materials are currently used. We measured differences in wear between alumina and cobalt-chrome heads with the same polyethylene liner.Patients and methods 39 patients (43 hips) with osteoarthritis were included in a study with 10-year follow-up. Wear was measured as proximal and 3D penetration of the head in the liner with radiostereometry (RSA). All the patients were followed clinically with Harris hip score (HHS) for up to 10 years. Radiolucent lines and osteolytic lesions were assessed on plain radiographs.Results With alumina heads, proximal wear (95% CI) after 10 years was 0.62 (0.44–0.80) mm as compared to 1.40 (1.00–1.80) mm in the cobalt-chrome group. For 3D wear, the results were 0.87 (0.69–1.04) mm for alumina heads and 1.78 (1.35–2.21) mm for cobalt-chrome heads. Median (range) HHS was 98 (77–100) in the alumina group and it was 93 (50–100) in the cobalt-chrome group (p = 0.01). We found no difference in osteolysis between the groups.InterpretationWe found better wear properties with alumina heads than with cobalt-chrome heads. We recommend the use of alumina heads in patients in whom a high wear rate might be anticipated.

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“…In relation to new materials, Gottliebsen et al 28 analyzed non-cemented arthroplasty procedures with and without hydroxyapatite and concluded that implants with hydroxyapatite wore out more rapidly, at 0.18 mm/year, versus 0.12 mm/year. Dahl et al 29 compared cemented prostheses with ceramic heads and with chromium–cobalt heads and observed that the wear rate in the former was 0.05 mm/year and the latter, 0.1 mm/year. Thus, non-cemented polyethylene pieces presented greater wear, which may have been related to their smaller thickness, as also observed in the present study.…”

Section: Discussionmentioning

confidence: 99%

Dimensional analysis of total hip arthroplasty polyethylenes

Schwartsmann

Spinelli

Boschin

et al. 2013

Revista Brasileira de Ortopedia (English Edition)

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Objective This paper performs a dimensional analysis of different total hip arthroplasty polyethylenes, cemented and non-cemented, Brazilian made and imported. Methods It was considered acetabular components with 50 mm for the 28 mm femoral heads. Dimensional analysis was performed on a 3D coordinate Carl-Zeiss robotic device. Polyethylene thickness and its external measurements (maximum diameter and diameter for the femoral head) were measured. Results The minimum thickness of the polyethylene was guaranteed on all tested components. The thickness of cemented acetabular varied from 19.185 mm to 25.358 mm, while the thickness of the non-cemented acetabular varied from 12.451 mm to 19.232 mm. The thickness was 27.96% lower in non-cemented acetabular components. With respect to the polyethylene acetabular cavity that receives the femoral head, all internal diameters exhibit at least 28 mm. In relation to the maximum outer diameter of the polyethylene, only one cemented acetabular component reached 50 mm in diameter. Conclusions There are large differences in measurements between brands and models analyzed. Cementless acetabular components have the smaller thickness. The diameters of non-cemented acetabular were also lower than those cemented at the expense of their need to insert into the metal-back.

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Less wear with aluminium-oxide heads than cobalt-chrome heads with ultra high molecular weight cemented polyethylene cups: A ten-year follow-up with radiostereometry

Cited by 19 publications

References 30 publications

Head Material Influences Survival of a Cemented Total Hip Prosthesis in the Norwegian Arthroplasty Register

Head Material Influences Survival of a Cemented Total Hip Prosthesis in the Norwegian Arthroplasty Register

More than 50% reduction of wear in polyethylene liners with alumina heads compared to cobalt-chrome heads in hip replacements

Dimensional analysis of total hip arthroplasty polyethylenes

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