Radiographic Methods for the Assessment of Polyethylene Wear After Total Hip Arthroplasty

McCalden, Richard W.; Naudie, Douglas D.R.; Yuan, Xunhua; Bourne, Robert B.

doi:10.2106/00004623-200510000-00025

Cited by 37 publications

(58 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our radiological evaluation did not reveal any implant dislocations as a consequence of excessive external forces and we were not able to note any radiological macroscopic signs of UHMWPE-wear on conventional X-ray images. However, well-established methods for measurement of polythylene wear after total hip replacement such as computer assisted edge-detection techniques or even radiostereometric analysis are still lacking for lumbar disc replacements and were thus not available in this study [44]. Persisting concerns regarding the future of the implant therefore remain a matter of debate.…”

Section: Discussionmentioning

confidence: 99%

Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance

Siepe¹,

Wiechert²,

Khattab

et al. 2007

Eur Spine J

View full text Add to dashboard Cite

Despite the increasing popularity of total lumbar disc replacement (TDR) in predominantly young and active patients, no previous study has addressed possibilities, limitations and potential risks regarding athletic performance following TDR. Mechanical concerns remain and the implant's resilience as regards its load-bearing capacity during sporting activities is unknown. Thirty-nine athletic patients fulfilled the inclusion criteria for this study. These patients participated in a large variety of different types of sport. Significant and lasting pain-relief was attained following TDR with a mean follow-up of 26.3 months (range 9-50.7 months; FU rate 97.4%). Sporting activity was resumed within the first 3 months (38.5%) to 6 months (30.7%) with peak performance being reached after 5.2 months. Thirty-seven patients (94.9%) achieved resumption of sporting activity. Athletic performance improved significantly in 33 patients (84.6%). Minor subsidence was observed in 13 patients (30%) within the first 3 months with no further implant migration thereafter in 12 patients. Participation in all types of sport recorded in this study was accessible for a high rate of patients up to the level of professional athletes as well as those participating in extreme sports. Preoperative participation in sport proved to be a strong positive predictor for highly satisfactory postoperative outcome following TDR. In a selected group of patients, however, preoperative inability to participate in sporting activities did not impair postoperative physical activity. Due to the young age of the patients and significant load increase exerted during athletic activities, persisting concerns regarding the future behaviour of the implant remain and will require longer follow-up, modified investigation techniques and larger patient cohorts.

show abstract

Section: Discussionmentioning

confidence: 99%

Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance

Siepe¹,

Wiechert²,

Khattab

et al. 2007

Eur Spine J

View full text Add to dashboard Cite

show abstract

“…Of the 105 sets of radiographs evaluated, 102 sets of hip radiographs were acceptable for wear measurements (inclusion rate of 97%). Two-dimensional wear analysis was performed using the method of Martell et al, a semiautomated, computerized, edge detection method [19,[25][26][27]29]. Each reading of linear wear (femoral head penetration) was expressed as a magnitude (millimeters) and a rate (millimeters per year) for each of the femoral head sizes.…”

Section: Methodsmentioning

confidence: 99%

Femoral Head Size and Wear of Highly Cross-linked Polyethylene at 5 to 8 Years

Lachiewicz

Heckman²,

Soileau

et al. 2009

Clin Orthop Relat Res

151

View full text Add to dashboard Cite

Wear of highly cross-linked polyethylene is reportedly independent of head size. To confirm that observation we asked in our population whether head size related to wear with one type of electron beam highly cross-linked polyethylene. Of 146 hips implanted, we evaluated complete clinical and radiographic data for 90 patients (102 hips or 70%). The minimum followup was 5 years (mean, 5.7 years; range, 5-8 years). The head size was selected intraoperatively based on the size of the acetabular component and presumed risk of dislocation. Polyethylene wear measurements were performed in one experienced laboratory using the method of Martell et al.There was no hip with pelvic or femoral osteolysis. The median linear wear rate was 0.028 mm/year (mean, 0.04 mm/year), and the median volumetric wear rate was 25.6 mm 3 /year (mean, 80.5 mm 3 /year). Median total volumetric wear was 41.0 mm 3 (mean, 98.5 mm 3 ). We found no association between femoral head size and the linear wear rate, but observed an association between larger (36-and 40-mm) head size and volumetric wear rate and total volumetric wear. Although the linear wear rate of polyethylene was not related to femoral head diameter, there was greater volumetric wear (156.6 mm 3 /year) with the 36-and 40-mm heads. Pending long-term studies of large head sizes, we advise caution in using larger femoral heads in young or active patients and in those with a low risk of dislocation.

show abstract

“…The presence of UHMWPE wear particles elicits an inflammatory reaction that is associated with periprosthetic bone resorption and implant failure [8,9,14,15,18,25,28]. The rate at which wear particles are generated, along with their size and volume are important factors in determining the likely occurrence of osteolysis [18,23]. Dumbleton et al in a review of the literature suggested osteolysis is infrequent with a wear rate less than 0.1 mm/year and almost absent at a rate less than 0.05 mm/ year [8].…”

Section: Introductionmentioning

confidence: 99%

“…Ebramzadeh et al showed that the PolyWare method has a tendency to overestimate the amount of wear by 0.18 mm [10]. Although RSA is an extremely precise method for wear analysis [4,19], its use has been limited by its expense, its requirement for prospective assessment, and the expertise required for analysis [23].…”

Section: Introductionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

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.

show abstract

Radiographic Methods for the Assessment of Polyethylene Wear After Total Hip Arthroplasty

Cited by 37 publications

References 60 publications

Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance

Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance

Femoral Head Size and Wear of Highly Cross-linked Polyethylene at 5 to 8 Years

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

Contact Info

Product

Resources

About