2020
DOI: 10.1002/jor.24577
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The effect of structural parameters of total hip arthroplasty on polyethylene liner wear behavior: A theoretical model analysis

Abstract: Using large femoral heads in total hip arthroplasty (THA) has been widely advocated to improve the function and longevity of the components. However, increasing the head size has been shown to accelerate polyethylene liner wear. Few studies have investigated the effect of other important structural parameters (such as polyethylene liner thickness, metal cup size, head‐liner conformity, loading conditions, etc.) on the biomechanical functions of the THAs. In this study, an analytical model was used to evaluate … Show more

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Cited by 11 publications
(10 citation statements)
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“…In osteoarthritis secondary to developmental dysplastic hip, a cup with a small diameter is often implanted, and the use of a femoral head with a diameter of 28 mm is a mandatory choice because the diameter of the femoral head is strictly related to the outer diameter of the cementless shell. Theoretically, prosthetic heads need to be enlarged to achieve better stability, which would imply that the liner thickness became thinner; a decrease in the polyethylene liner thickness or a decrease in the head-liner conformity leads to higher peak contact stresses, smaller contact areas, and, consequently, lower biomechanical wear factor [23,24]. In this report, the use of a femoral head diameter of 28 mm was reserved for 56 of the 100 implants, mainly because the outer diameter of the cementless shell was 48 mm or less in 46 THAs.…”
Section: Discussionmentioning
confidence: 99%
“…In osteoarthritis secondary to developmental dysplastic hip, a cup with a small diameter is often implanted, and the use of a femoral head with a diameter of 28 mm is a mandatory choice because the diameter of the femoral head is strictly related to the outer diameter of the cementless shell. Theoretically, prosthetic heads need to be enlarged to achieve better stability, which would imply that the liner thickness became thinner; a decrease in the polyethylene liner thickness or a decrease in the head-liner conformity leads to higher peak contact stresses, smaller contact areas, and, consequently, lower biomechanical wear factor [23,24]. In this report, the use of a femoral head diameter of 28 mm was reserved for 56 of the 100 implants, mainly because the outer diameter of the cementless shell was 48 mm or less in 46 THAs.…”
Section: Discussionmentioning
confidence: 99%
“…Although other recent studies have developed an analysis method using an analytical model of contact pressure as a predictor of risk of wear [ 26 ], we believe that modeling many different variables using FEA provides a more reliable order-of-magnitude estimation.…”
Section: Discussionmentioning
confidence: 99%
“…A new low-frictional torque arthroplasty theory can be established owing to their sliding characteristics and better wettability than PE: with ceramic components (inlay and head), due to a lower coefficient of friction, it is possible to enlarge the femoral head diameter without increasing the frictional torque and to grant a wider range of movement that will last because ceramic-ceramic bearings avoid wear. When a PE liner develops wear, the center of rotation migrates centrally and/or cranially, and the deeper the head, the more restricted the range of motion becomes; in fact, late dislocation can be the first clinical sign of wear, with a cumulative risk of firsttime dislocation that is 2-fold and 3-fold at 10 and 20 years, respectively, when compared to the 1-year follow-up [14,[30][31][32][33][34][35][36][37][38][39][40][41][42][43]. Breakage of ceramic components is a ceramic-specific issue; we have not seen any fractures in our series.…”
Section: Discussionmentioning
confidence: 99%
“…Inadequate polyethylene thickness is identified as the source of plastic particle-mediated osteolysis, not only in conventional polyethylene [32] but also in vitamin E-diffused HXLPE, and hence significant liner thinning is not advised [33]: Higher peak contact loads and smaller contact areas result from a decrease in polyethylene liner thickness or headliner conformance, resulting in reduced biomechanical wear factors. On the other hand, since larger femoral heads have been widely advocated to improve implant stability and range of motion, especially in patients with spinopelvic alignment, such as patients with hip osteoarthritis secondary to DDH, prosthetic heads must be enlarged, implying a reduction in liner thickness [34][35][36][37][38][39][40].…”
Section: Alumina-on-alumina Total Hip Replacement In Developmental Dy...mentioning
confidence: 99%
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