Periprosthetic bone loss in total hip arthroplasty. Polyethylene wear debris and the concept of the effective joint space.

Schmalzried, Thomas P.; Jasty, Murali; Harris, W.H.

doi:10.2106/00004623-199274060-00006

Cited by 1,004 publications

(461 citation statements)

References 0 publications

Supporting

Mentioning

429

Contrasting

Unclassified

Order By: Relevance

“…Creep does not produce debris. However, creep of the PE may cause deformation of a thin layer of cement and may accelerate the passing of debris into the surrounding bone [29]. With an alumina cup there is no creep but it is not possible to distinguish on the radiographs the edge of the femoral head from the articulation surface of the acetabular component and wear is present both on the femoral head and on the cup.…”

Section: Discussionmentioning

confidence: 99%

Ceramic-Ceramic Bearing Decreases Osteolysis: A 20-year Study versus Ceramic-Polyethylene on the Contralateral Hip

Hernigou

Zilber

Filippini

et al. 2009

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Although ceramic implants have been in use for many years and they are intended to minimize wear debris it is unknown whether alumina-on-alumina or alumina-onpolyethylene produce less wear and osteolysis. We therefore investigated wear and osteolysis on 28 bilateral arthroplasties (one ceramic-ceramic and the contralateral ceramic-polyethylene) of patients who had survived 20 years without revision and without loosening of either hip. Osteolysis was identified on anteroposterior pelvic radiographs and 3-D volume from CT scans. The number of osteolytic lesions detected with CT scan was higher than with radiographs. The number of lesions was higher on the side with the alumina-PE couple. With a similar length of followup on each side, the surface and the volume of osteolysis were consistently higher on the side with the alumina-PE couple. We found no correlation between the volume of osteolysis and the volume of estimated wear in each couple of friction. Hips with osteolysis had a lower Harris score.

show abstract

Section: Discussionmentioning

confidence: 99%

Ceramic-Ceramic Bearing Decreases Osteolysis: A 20-year Study versus Ceramic-Polyethylene on the Contralateral Hip

Hernigou

Zilber

Filippini

et al. 2009

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…During the 1990s, clinical concern about osteolysis and loosening of joint arthroplasties prompted a shift in the perception of polyethylene among orthopaedic researchers and surgeons [59,67,123,138]. Polyethylene used in orthopaedics was subjected to greater scrutiny than ever before in terms of its manufacturing processes, sterilization techniques, wear mechanisms, and degradation chemistry.…”

Section: History and Development Of Hxlpementioning

confidence: 99%

History and Systematic Review of Wear and Osteolysis Outcomes for First-generation Highly Crosslinked Polyethylene

Kurtz

Gawel

Patel

2011

Clinical Orthopaedics &Amp; Related Research

411

282

View full text Add to dashboard Cite

Background Highly crosslinked polyethylene (HXLPE) was introduced to reduce wear and osteolysis in total joint arthroplasty. While many studies report wear and osteolysis associated with HXLPE, analytical techniques, clinical study design and followup, HXLPE formulation and implant design characteristics, and patient populations differ substantially among investigations, complicating a unified perspective. Questions/purposes Literature on first-generation HXLPE was summarized. We systematically reviewed the radiographic wear data and incidence of osteolysis for HXLPE in hip and knee arthroplasty. Methods PubMed identified 391 studies; 28 met inclusion criteria for a weighted-averages analysis of two-dimensional femoral head penetration rates. To determine the incidence of osteolysis, we estimated a pooled odds ratio using a random-effects model.Results Weighted-averages analyses of femoral head penetration rates in HXLPE liners and conventional UHMWPE liners resulted, respectively, in a mean twodimensional linear penetration rate of 0.042 mm/year based on 28 studies (n = 1503 hips) and 0.137 mm/year based on 18 studies (n = 695 hips). The pooled odds ratio for the risk of osteolysis in HXLPE versus conventional liners was 0.13 (95% confidence interval, 0.06-0.27) among studies with minimum 5-year followup. We identified two clinical studies of HXLPE in TKA, preventing systematic analysis of outcomes. Conclusions HXLPE liner studies consistently report lower femoral head penetration and an 87% lower risk of osteolysis. Reduction in femoral head penetration or osteolysis risk is not established for large-diameter ([ 32 mm) metallic femoral heads or ceramic femoral heads of any size. Few studies document the clinical performance of HXLPE in knees.

show abstract

“…Release of metal particles and metal ions can have further adverse effects: they can be transported to areas other than the joint cavities and initiate further osteolysis away from the affected joint. This concept of "effective joint space" has been described in detail by Schmalzried et al (1992).…”

Section: Metal-induced Immune Responsesmentioning

confidence: 99%

Metal-on-metal hip resurfacing arthroplasty: A review of periprosthetic biological reactions

et al. 2008

View full text Add to dashboard Cite

Periprosthetic bone loss in total hip arthroplasty. Polyethylene wear debris and the concept of the effective joint space.

Cited by 1,004 publications

References 0 publications

Ceramic-Ceramic Bearing Decreases Osteolysis: A 20-year Study versus Ceramic-Polyethylene on the Contralateral Hip

Ceramic-Ceramic Bearing Decreases Osteolysis: A 20-year Study versus Ceramic-Polyethylene on the Contralateral Hip

History and Systematic Review of Wear and Osteolysis Outcomes for First-generation Highly Crosslinked Polyethylene

Metal-on-metal hip resurfacing arthroplasty: A review of periprosthetic biological reactions

Contact Info

Product

Resources

About