Long-Term Wear-Related Complications of Cross-Linked Versus Conventional Polyethylene After Total Hip Arthroplasty: A Meta-Analysis

Yoon, Byung‐Ho; Park, Jung-Wee; Lee, Yong Seuk; Koo, Kyung‐Hoi; Chang, Chong Bum

doi:10.1016/j.arth.2022.05.013

Cited by 11 publications

(4 citation statements)

References 38 publications

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“…The long-term performance of cross-linked polyethylene was investigated by Yoon et al, who reported on the results of a meta-analysis of studies with a minimum follow-up of 10 years comparing wear-related complications and revision surgery between conventional and highly cross-linked polyethylene 18 . Highly cross-linked polyethylene significantly decreased the risk of overall osteolysis (OR, 0.30 [95% CI, 0.15 to 0.60]), linear wear rate (0.09 mm/year [95% CI, 0.06 to 0.12 mm/year]), excessive wear (OR, 0.10 [95% CI, 0.06 to 0.19]), overall wear-related revision (OR, 0.08 [95% CI, 0.04 to 0.19], and aseptic revision (OR, 0.23 [95% CI, 0.07 to 0.76]).…”

Section: Implant Design and Related Outcomesmentioning

confidence: 99%

What’s New in Hip Surgery

Morgan

Gannon

2023

Journal of Bone and Joint Surgery

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Section: Implant Design and Related Outcomesmentioning

confidence: 99%

What’s New in Hip Surgery

Morgan

Gannon

2023

Journal of Bone and Joint Surgery

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“…Numerous studies have demonstrated the excellent long-term durability, implant survivorship, and favorable clinical outcomes of modern THA [7]. Factors contributing to the success of THA include appropriate patient selection, meticulous surgical techniques adhering to principles of biomechanics, optimized implant sizing/positioning, bone preservation, accelerated rehabilitation protocols, and the prevention of complications like instability, infection, and thromboembolic events [8][9][10]. Continued research into implant designs, bearing surfaces, fixation methods, and novel technologies further improves outcomes and longevity [11].…”

Section: Introductionmentioning

confidence: 99%

Radiological Comparison of Canal Fill between Collared and Non-Collared Femoral Stems: A Two-Year Follow-Up after Total Hip Arthroplasty

Ashkenazi,

Benady,

Ben Zaken

et al. 2024

J. Imaging

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Collared femoral stems in total hip arthroplasty (THA) offer reduced subsidence and periprosthetic fractures but raise concerns about fit accuracy and stem sizing. This study compares collared and non-collared stems to assess the stem–canal fill ratio (CFR) and fixation indicators, aiming to guide implant selection and enhance THA outcomes. This retrospective single-center study examined primary THA patients who received Corail cementless stems between August 2015 and October 2020, with a minimum of two years of radiological follow-up. The study compared preoperative bone quality assessments, including the Dorr classification, the canal flare index (CFI), the morphological cortical index (MCI), and the canal bone ratio (CBR), as well as postoperative radiographic evaluations, such as the CFR and component fixation, between patients who received a collared or a non-collared femoral stem. The study analyzed 202 THAs, with 103 in the collared cohort and 99 in the non-collared cohort. Patients’ demographics showed differences in age (p = 0.02) and ASA classification (p = 0.01) but similar preoperative bone quality between groups, as suggested by the Dorr classification (p = 0.15), CFI (p = 0.12), MCI (p = 0.26), and CBR (p = 0.50). At the two-year follow-up, femoral stem CFRs (p = 0.59 and p = 0.27) were comparable between collared and non-collared cohorts. Subsidence rates were almost doubled for non-collared patients (19.2 vs. 11.7%, p = 0.17), however, not to a level of clinical significance. The findings of this study show that both collared and non-collared Corail stems produce comparable outcomes in terms of the CFR and radiographic indicators for stem fixation. These findings reduce concerns about stem under-sizing and micro-motion in collared stems. While this study provides insights into the collar design debate in THA, further research remains necessary.

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“…The earliest model for hip implants articulated a metallic femoral head with a polyethylene liner (metal-on-polyethylene (MoP)), a design that was built upon by the introduction of crosslinked polyethylene, which facilitated improved long-term durability [3,4]. Despite these benefits, MoP implants are susceptible to aseptic loosening over time with subsequent degenerative osteolysis of the acetabular and femoral components due to progressive wear and tear [5]. Notably, while the progression of osteolysis secondary to polyethylene wear may be slowed down using non-steroidal anti-inflammatory drugs (NSAIDs) and bisphosphonate therapy, definitive treatment often necessitates a revision operation [6].…”

Section: Introductionmentioning

confidence: 99%

Reactive Peri-Arthroplasty Pseudotumors: A Rare Cause of Hip Pain and Iatrogenic Sciatica

Ahmed,

Grabie,

Loeffler

et al. 2023

Cureus

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Total hip arthroplasty (THA) is the preferred treatment for patients with hip joint disorders refractory to conservative management. While original implants were designed to articulate a metallic femoral head onto a polyethylene liner, the popularity of "metal-on-metal" (MoM) hip implants surged in the early 21st century due to their perceived superior long-term durability and lower revision rates. However, subsequent followup studies showed high failure rates due to inflammatory responses to periprosthetic metallic debris leading to lymphocytic proliferation, soft tissue necrosis or fibrosis, systemic metal toxicity, and/or the development of cystic pseudotumors. Although these discoveries resulted in a significant decrease in MoM THA and revision procedures, the majority of MoM hip implants persist in the adult population. In this case report and review, we report the presentation, diagnostic work-up, and management of an 84-year-old status-post MoM THA who presented with unilateral leg tenderness and poor ambulation secondary to pseudotumorinduced sciatica.

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Long-Term Wear-Related Complications of Cross-Linked Versus Conventional Polyethylene After Total Hip Arthroplasty: A Meta-Analysis

Cited by 11 publications

References 38 publications

What’s New in Hip Surgery

What’s New in Hip Surgery

Radiological Comparison of Canal Fill between Collared and Non-Collared Femoral Stems: A Two-Year Follow-Up after Total Hip Arthroplasty

Reactive Peri-Arthroplasty Pseudotumors: A Rare Cause of Hip Pain and Iatrogenic Sciatica

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