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Published in: HSS Journal ® 1/2020

01-02-2020 | Hip-TEP | Original Article

The Survivorship of the Uncemented Iso-Elastic Monoblock Acetabular Component at a Mean of 6-Year Follow-up

Authors: T. E. Snijders, MD, J. J. Halma, MD, J. R. A. Massier, S. M. van Gaalen, MD, PhD, A. de Gast, MD, PhD

Published in: HSS Journal ® | Issue 1/2020

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Abstract

Background

Aseptic loosening, caused by wear and osteolysis, is the most frequent reason for hip replacement revision in the UK. To prevent aseptic loosening, an acetabular component with vitamin E added to irradiated highly cross-linked polyethylene (HXLPE) was developed to reduce oxidative degradation.

Questions/Purposes

A prior study of the vitamin E–blended HXLPE acetabular component after 2 years of follow-up reported no adverse reactions or abnormal mechanical behavior. To further examine this hypothesis of reducing wear and osteolysis, we sought to evaluate outcomes after 6-year follow-up.

Methods

A cohort of 95 of the 112 initial patients (84.2%) completed the 6 years of follow-up after receiving a vitamin E–blended HXLPE acetabular component. Evaluation was performed in terms of clinical (visual analog scale [VAS] score, VAS score with weight-bearing, VAS score for satisfaction, and Harris Hip Score) and radiological (inclination, polar gap, radiolucencies, migration, and 2-D linear femoral head penetration rate) assessment.

Results

The mean VAS score for patient satisfaction was 8.75 and the mean Harris Hip Score was 91.8. There were two revisions because of deep infections and one because of a peri-prosthetic femoral fracture. Two acetabular components migrated initially; however, delayed acetabular stabilization occurred. Both patients had good clinical scores at 72 months. The mean femoral head penetration rate was 0.036 mm/year.

Conclusions

This prospective cohort study has shown no adverse reactions concerning the vitamin E additive, promising wear rates, no signs of osteolysis, a 100% survival rate for aseptic loosening, and an all-cause survivorship percentage of 97.4% at 6 years of follow-up.
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Literature
1.
go back to reference Bracco P, Brunella V, Zanetti M, Luda M, Costa L. Stabilisation of ultra-high molecular weight polyethylene with vitamin E. Polymer Degradation and Stability. 2007;92(12):2155–2162.CrossRef Bracco P, Brunella V, Zanetti M, Luda M, Costa L. Stabilisation of ultra-high molecular weight polyethylene with vitamin E. Polymer Degradation and Stability. 2007;92(12):2155–2162.CrossRef
2.
go back to reference Bracco P, Bellare A, Bistolfi A, Affatato S. Ultra-high molecular weight polyethylene: influence of the chemical, physical and mechanical properties on the wear behavior. a review. Materials (Basel). 2017;10(7). E791.CrossRef Bracco P, Bellare A, Bistolfi A, Affatato S. Ultra-high molecular weight polyethylene: influence of the chemical, physical and mechanical properties on the wear behavior. a review. Materials (Basel). 2017;10(7). E791.CrossRef
3.
go back to reference Brokelman RBG, Haverkamp D, van Loon C, Hol A, van Kampen A, Veth R. The validation of the visual analogue scale for patient satisfaction after total hip arthroplasty. Eur Orthop Traumatol. 2012;3:101–105.CrossRef Brokelman RBG, Haverkamp D, van Loon C, Hol A, van Kampen A, Veth R. The validation of the visual analogue scale for patient satisfaction after total hip arthroplasty. Eur Orthop Traumatol. 2012;3:101–105.CrossRef
4.
go back to reference Callary S, Solomon L, Holubowycz O, Campbell D, Munn Z, Howie D. Wear of highly crosslinked polyethylene acetabular components. Acta Orthop. 2015;86:159–168.CrossRef Callary S, Solomon L, Holubowycz O, Campbell D, Munn Z, Howie D. Wear of highly crosslinked polyethylene acetabular components. Acta Orthop. 2015;86:159–168.CrossRef
5.
go back to reference Dumbleton J, Manley M, Edidin A. A literature review of the association between wear rate and osteolysis in total hip arthroplasty. J Arthroplasty. 2002;17:649–661.CrossRef Dumbleton J, Manley M, Edidin A. A literature review of the association between wear rate and osteolysis in total hip arthroplasty. J Arthroplasty. 2002;17:649–661.CrossRef
6.
go back to reference Gasser B. Biomechanical principles and studies. In: Hip-joint surgery: the RM cup—long-term experience with an elastic monobloc acetabular implant. Horne G [ed]. Hamburg, Germany: Einhorn-Presse-Verlag. 2008. Gasser B. Biomechanical principles and studies. In: Hip-joint surgery: the RM cup—long-term experience with an elastic monobloc acetabular implant. Horne G [ed]. Hamburg, Germany: Einhorn-Presse-Verlag. 2008.
7.
go back to reference Geerdink CH, Grimm B, Vencken W, Heyligers IC, Tonino AJ. The determination of linear and angular penetration of the femoral head into the acetabular component as an assessment of wear in total hip replacement: a comparison of four computer-assisted methods. J Bone Joint Surg Br. 2008;90:839–846.CrossRef Geerdink CH, Grimm B, Vencken W, Heyligers IC, Tonino AJ. The determination of linear and angular penetration of the femoral head into the acetabular component as an assessment of wear in total hip replacement: a comparison of four computer-assisted methods. J Bone Joint Surg Br. 2008;90:839–846.CrossRef
8.
go back to reference Halma J, Señaris J, Delfosse D, Lerf R, Oberbach T, van Gaalen S, de Gast A. Edge loading does not increase wear rates of ceramic-on-ceramic and metal-on-polyethylene articulations. J Biomed Mater Res Part B Appl Biomater. 2014;102:1627–1638.CrossRef Halma J, Señaris J, Delfosse D, Lerf R, Oberbach T, van Gaalen S, de Gast A. Edge loading does not increase wear rates of ceramic-on-ceramic and metal-on-polyethylene articulations. J Biomed Mater Res Part B Appl Biomater. 2014;102:1627–1638.CrossRef
9.
go back to reference Halma J, Eshuis R, Vogely HC, van Gaalen S, de Gast A. An uncemented iso-elastic monoblock acetabular component: preliminary results. J Arthroplasty. 2015;30:615–621.CrossRef Halma J, Eshuis R, Vogely HC, van Gaalen S, de Gast A. An uncemented iso-elastic monoblock acetabular component: preliminary results. J Arthroplasty. 2015;30:615–621.CrossRef
10.
go back to reference Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–755.CrossRef Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–755.CrossRef
11.
go back to reference Ihle M, Mai S, Pfluger D, Siebert W. The results of the titanium-coated RM acetabular component at 20 years: a long-term follow-up of an uncemented primary total hip replacement. J Bone Joint Surg Br. 2008;90:1284–1290.CrossRef Ihle M, Mai S, Pfluger D, Siebert W. The results of the titanium-coated RM acetabular component at 20 years: a long-term follow-up of an uncemented primary total hip replacement. J Bone Joint Surg Br. 2008;90:1284–1290.CrossRef
12.
go back to reference Jiang Y, Jia T, Wooley P, Yang S. Current research in the pathogenesis of aseptic implant loosening associated with particulate wear debris. Acta Orthop Belg. 2013;79:1–9.PubMed Jiang Y, Jia T, Wooley P, Yang S. Current research in the pathogenesis of aseptic implant loosening associated with particulate wear debris. Acta Orthop Belg. 2013;79:1–9.PubMed
13.
go back to reference Kurtz S, Gawel H, Patel J. History and systematic review of wear and osteolysis outcomes for first-generation highly crosslinked polyethylene. Clin Orthop Relat Res. 2011;469:2262–2277.CrossRef Kurtz S, Gawel H, Patel J. History and systematic review of wear and osteolysis outcomes for first-generation highly crosslinked polyethylene. Clin Orthop Relat Res. 2011;469:2262–2277.CrossRef
14.
go back to reference Meneghini RM, Ford K, McCollough C, Hanssen A, Lewallen D. Bone remodeling around porous metal cementless acetabular components. J Arthroplasty. 2010;25:741–747.CrossRef Meneghini RM, Ford K, McCollough C, Hanssen A, Lewallen D. Bone remodeling around porous metal cementless acetabular components. J Arthroplasty. 2010;25:741–747.CrossRef
16.
go back to reference Nebergall AK, Greene ME, Laursen MB, Nielsen PT, Malchau H, Troelsen A. Vitamin E diffused highly cross-linked polyethylene in total hip arthroplasty at five years: a randomised controlled trial using radiostereometric analysis. Bone Joint J. 2017;99-B:577–584.CrossRef Nebergall AK, Greene ME, Laursen MB, Nielsen PT, Malchau H, Troelsen A. Vitamin E diffused highly cross-linked polyethylene in total hip arthroplasty at five years: a randomised controlled trial using radiostereometric analysis. Bone Joint J. 2017;99-B:577–584.CrossRef
17.
go back to reference Pakvis D, Biemond L, van Hellemondt G, Spruit M. A cementless elastic monoblock socket in young patients: a ten to 18-year clinical and radiological follow-up. Int Orthop. 2011;35:1445–1451.CrossRef Pakvis D, Biemond L, van Hellemondt G, Spruit M. A cementless elastic monoblock socket in young patients: a ten to 18-year clinical and radiological follow-up. Int Orthop. 2011;35:1445–1451.CrossRef
18.
go back to reference Stihsen C, Pabinger C, Radl R, Rehak P, Windhager R. Migration of the Duraloc cup after 5 years. Int Orthop. 2008;32:791–794.CrossRef Stihsen C, Pabinger C, Radl R, Rehak P, Windhager R. Migration of the Duraloc cup after 5 years. Int Orthop. 2008;32:791–794.CrossRef
19.
go back to reference Wyatt M, Weidner J, Pfluger D, Beck M. The RM Pressfit vitamys: 5-year Swiss experience of the first 100 cups. Hip Int. 2017;27(4):368–372.CrossRef Wyatt M, Weidner J, Pfluger D, Beck M. The RM Pressfit vitamys: 5-year Swiss experience of the first 100 cups. Hip Int. 2017;27(4):368–372.CrossRef
20.
go back to reference Yousif E, Haddad R. Photodegradation and photostabilization of polymers, especially polystyrene: review. Springerplus. 2013;2:398.CrossRef Yousif E, Haddad R. Photodegradation and photostabilization of polymers, especially polystyrene: review. Springerplus. 2013;2:398.CrossRef
Metadata
Title
The Survivorship of the Uncemented Iso-Elastic Monoblock Acetabular Component at a Mean of 6-Year Follow-up
Authors
T. E. Snijders, MD
J. J. Halma, MD
J. R. A. Massier
S. M. van Gaalen, MD, PhD
A. de Gast, MD, PhD
Publication date
01-02-2020
Publisher
Springer US
Keywords
Hip-TEP
Hip-TEP
Published in
HSS Journal ® / Issue 1/2020
Print ISSN: 1556-3316
Electronic ISSN: 1556-3324
DOI
https://doi.org/10.1007/s11420-018-09658-8

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