Once Annealed Highly Cross-Linked Polyethylene Exhibits Low Wear at 9 to 15 Years

DʼAntonio, James A.; Capello, William N.; Ramakrishnan, Rama

doi:10.3928/01477447-20160414-03

Cited by 3 publications

(1 citation statement)

References 35 publications

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“…Further, a controversial topic is the argument for [54][55][56][57][58] or against [30,[59][60][61][62][63] compared head penetration rates of irradiated and remelted HXLPE (0.032mm/year) and onceannealed HXLPE (0.031 mm/year) using all 26mm CoCr heads at 8.2 years follow-up and showed equivalent head penetration rates [49] which corroborate previous studies with different femoral head sizes, materials and polyethylene thickness. [48,64] Still, Snir and colleagues found the wear rate at 10 years for this once-annealed polyethylene bearing against a 28mm…”

Section: Accepted Manuscriptmentioning

confidence: 95%

Femoral Head Penetration Rates of Second-Generation Sequentially Annealed Highly Cross-Linked Polyethylene at Minimum Five Years

Deckard

Meneghini

2019

The Journal of Arthroplasty

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Background: Highly cross-linked polyethylene (HXLPE) liners in total hip arthroplasty (THA) have demonstrated decreased wear rates, resilience to cup orientation, and reduced osteolysis compared to conventional polyethylene. Sequential irradiation and annealing below the melting temperature is unique compared to most HXLPE which is irradiated and remelted. This study purpose was to provide minimum five-year femoral head penetration rates of sequentially annealed HXLPE in primary THA. Methods: A retrospective review of a prospectively collected database identified 198 consecutive, cementless primary THAs utilizing sequentially annealed HXLPE (X3 ™ , Stryker, Mahwah, NJ). Operative technique was standardized. Radiographs were analyzed utilizing the Martell method with minimum five-year and one-year radiographs as baseline to minimize the initial bedding-in period. Results: Seventy-seven hips with minimum five-year follow-up were analyzed. Mean steadystate linear and volumetric head penetration rates were 0.095 mm/year and 76 mm 3 /year. Volumetric head penetration was significantly less for 32mm compared to 36mm (p=0.028). In addition, less head penetration was observed for ceramic 32mm heads at nearly half the rate compared to CoCr 36mm heads (p≥0.092). No correlations existed between penetration rates and age, BMI, UCLA Activity Level, polyethylene thickness, cup inclination or anteversion (p≥0.10). No radiographic osteolysis was observed. Conclusion: Surprisingly, linear head penetration rates of sequentially annealed HXLPE were nearly identical to the osteolysis threshold for conventional polyethylene and greater than reports of irradiated and remelted HXLPE. Further, this data corroborates reports that HXLPE is resilient to cup orientation and demographic variables. Longer term follow-up is recommended.

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Section: Accepted Manuscriptmentioning

confidence: 95%

Femoral Head Penetration Rates of Second-Generation Sequentially Annealed Highly Cross-Linked Polyethylene at Minimum Five Years

Deckard

Meneghini

2019

The Journal of Arthroplasty

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In-vitro wear simulation of sequentially crosslinked and annealed polyethylene acetabular liners: 14 years of results

Buell

Loving

Herrera

et al. 2017

Wear

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Long-term Wear Data From a Prospective Multicenter Study of Second-Generation Highly Cross-linked Polyethylene Inserts in Total Hip Arthroplasty

Bonutti¹,

Meško²,

Ramakrishnan³

2018

Orthopedics

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In a prospective multicenter trial on highly cross-linked polyethylene inserts in patients undergoing total hip arthroplasty, 118 patients consented to 10-year follow-up. Medium-term follow-up results showed low wear at 5 and 7 years after surgery. The current study focuses on long-term data at 10 years. Patients were followed up by either phone or office visit to collect long-term clinical data including Harris hip score and adverse events. There were 2 deaths and 2 revisions, 1 at 6.5 years for pelvic cyst and severe pain and another at 8.0 years for recurrent dislocation. For wear analysis, suitable radiographic images for 48 patients (52 hips) at minimum 10-year follow-up were available. Mean age of the cohort was 62.5 years (62% female). Femoral head penetration was measured using Martell's method from the radiographic images between the 6-week and the subsequent follow-ups. Polyethylene wear rate was calculated from the penetration data. Descriptive statistics were performed. There was no evidence of significant oxidation or locking mechanism failure. Mean Harris hip score of the group was 94.3. No osteolysis was noted by an independent radiographic reviewer. The slope of the bestfit regression line to the femoral head penetration data, which represents the overall linear wear rate of the polyethylene, was 0.014 mm/y. The wear rate was significantly below the 0.100 mm/y critical threshold for development of osteolysis. Volumetric wear rate was calculated to be 11.6 mm/y. The second-generation highly cross-linked polyethylene acetabular inserts had low wear in the long term (10.3 years) with no incidence of osteolysis. [Orthopedics. 2018; 41(4):e529-e533.].

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Once Annealed Highly Cross-Linked Polyethylene Exhibits Low Wear at 9 to 15 Years

Cited by 3 publications

References 35 publications

Femoral Head Penetration Rates of Second-Generation Sequentially Annealed Highly Cross-Linked Polyethylene at Minimum Five Years

Femoral Head Penetration Rates of Second-Generation Sequentially Annealed Highly Cross-Linked Polyethylene at Minimum Five Years

In-vitro wear simulation of sequentially crosslinked and annealed polyethylene acetabular liners: 14 years of results

Long-term Wear Data From a Prospective Multicenter Study of Second-Generation Highly Cross-linked Polyethylene Inserts in Total Hip Arthroplasty

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