Second-generation Annealed Highly Cross-linked Polyethylene Exhibits Low Wear

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

doi:10.1007/s11999-011-2177-3

Cited by 69 publications

(51 citation statements)

References 5 publications

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“…Highly XLPE was designed to decrease or eliminate polyethylene wear, decrease the incidence and severity of osteolysis, and hopefully increase the lifespan of THA to the 20-to 30-year range. A number of XLPE formulations have been available for the past decade and have shown decreased wear and osteolysis at short-to medium-term followup times [2,3,5,7,9,22]. The senior author (PFL) has exclusively used one uncemented acetabular component with one electron beam, remelted XLPE over the past 14 years but with different femoral head sizes selected based on anatomic and demographic variables.…”

Section: Discussionmentioning

confidence: 99%

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Wear and Osteolysis of Highly Crosslinked Polyethylene at 10 to 14 Years: The Effect of Femoral Head Size

Lachiewicz

Soileau

Martell

2016

Clinical Orthopaedics &Amp; Related Research

110

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Background Highly crosslinked polyethylene (XLPE) was introduced to decrease periprosthetic osteolysis related to polyethylene wear, a major reason for revision of total hip arthroplasty. However, there are few reports of wear and osteolysis at 10 years postoperatively. Questions/purposes (1) What are the linear and volumetric wear rates of XLPE at 10 to 14 years? (2) What is the relationship among linear wear, volumetric wear, and femoral head size? (3) What proportion of hips developed osteolysis and was there a relationship between osteolysis and femoral head size or polyethylene wear?Methods We evaluated a previously reported cohort of 84 hips (72 patients) with one design of an uncemented acetabular component and one electron beam 10-kGy irradiated and remelted XLPE at a mean followup of 11 years (range, 10-14 years). The choice of femoral head size was based on several factors, including the outer diameter size of the acetabular component implanted, the perceived risk of dislocation (including the history of alcohol abuse and patient age), and liner availability from the manufacturer. The femoral head sizes used were 26 mm in 10 hips (12%), 28 mm in 31 hips (37%), 32 mm in 31 hips (37%), 36 mm in eight hips (10%), and 40 mm in four hips (5%). Measurements of linear and volumetric wear were performed in one experienced laboratory by the Martell method and analyzed using the first-to-last method. Standard radiographs, with additional Judet views, were used to detect periprosthetic osteolysis. Statistical analysis of wear and osteolysis compared with head size was performed. Results For the entire cohort, the median linear wear rate as 0.024 mm/year (95% confidence interval [CI], 0.016-0.030) and the median volumetric wear rate was 12.19 mm 3 /year (95% CI, 6.6-15.7). With the numbers available, we found no association between femoral head size and linear wear rate. However, larger femoral heads were associated with more volumetric wear; 36/40-mm femoral heads had higher volumetric wear (median 26.1; 95% CI, 11.3-47.1) than did 26-mm heads (median 3.1; 95% CI, 0.7-12.3), 28-mm heads (median 12.3; 95% CI, 3.0-19.3), and 32-mm heads (median 12.9; 95% CI, 6.6-16.8; p = 0.02). Small osteolytic lesions were noted in 12 hips (14%), but with the numbers available, there was no association with head size or volumetric wear rates. Conclusions This uncemented acetabular component and this particular XLPE had low rates of linear and volumetric wear. Small osteolytic lesions were noted at 10 to 14 years

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Section: Discussionmentioning

confidence: 99%

“…This material has been studied in vitro and has decreased wear rates compared with conventional polyethylene in hip simulator studies [10]. Clinical studies of XLPE in small series of patients have confirmed these laboratory studies with a 45% to 99% reduction in wear compared with conventional polyethylene at 3 to 5 years [3,5,7,9,22].…”

Section: Introductionmentioning

confidence: 97%

Wear and Osteolysis of Highly Crosslinked Polyethylene at 10 to 14 Years: The Effect of Femoral Head Size

Lachiewicz

Soileau

Martell

2016

Clinical Orthopaedics &Amp; Related Research

110

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“…Of significance, X3, a second generation material which is sequentially irradiated and annealed has been reported to have a reduction in wear of 58% compared to single stage irradiated and annealed first generation materials [23]. Wang et al claimed that sequential irradiation and annealing have led to materials with crosslinking levels, fatigue and mechanical strengths of first generation annealed materials, yet with oxidation resistance equivalent to virgin UHMWPE [24].…”

Section: Discussionmentioning

confidence: 99%

Oxidation of Second Generation Sequentially Irradiated and Annealed Highly Cross-Linked X3™ Polyethylene Tibial Bearings

Kop

Pabbruwe

Keogh

et al. 2015

The Journal of Arthroplasty

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“…Bench testing suggests that these newer materials may be superior, and clinical studies are currently underway [1][2][3][4]. Randomized trials comparing the performance of first and secondgeneration HXLPEs to look at linear and volumetric wear, incidence of osteolysis, and implant survivorship will determine the ultimate benefits of second-generation materials.…”

Section: How Do We Get There?mentioning

confidence: 99%

CORR Insights®: Wear and Osteolysis of Highly Crosslinked Polyethylene at 10 to 14 Years: The Effect of Femoral Head Size

DʼAntonio

2016

Clinical Orthopaedics &Amp; Related Research

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Second-generation Annealed Highly Cross-linked Polyethylene Exhibits Low Wear

Abstract: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

Cited by 69 publications

References 5 publications

Wear and Osteolysis of Highly Crosslinked Polyethylene at 10 to 14 Years: The Effect of Femoral Head Size

Wear and Osteolysis of Highly Crosslinked Polyethylene at 10 to 14 Years: The Effect of Femoral Head Size

Oxidation of Second Generation Sequentially Irradiated and Annealed Highly Cross-Linked X3™ Polyethylene Tibial Bearings

CORR Insights®: Wear and Osteolysis of Highly Crosslinked Polyethylene at 10 to 14 Years: The Effect of Femoral Head Size

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