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Clinical Orthopaedics and Related Research®

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01-11-2012 | Symposium: Papers Presented at the 2011 Meeting of the International Hip Society

Highly Crosslinked Polyethylene Does Not Reduce Aseptic Loosening in Cemented THA 10-year Findings of a Randomized Study

Authors: Per-Erik Johanson, MD, Georgios Digas, MD, PhD, Peter Herberts, MD, PhD, Jonas Thanner, MD, PhD, Johan Kärrholm, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 11/2012

Abstract

Background

Polyethylene (PE) wear particles are believed to cause aseptic loosening and thereby impair function in hip arthroplasty. Highly crosslinked polyethylene (XLPE) has low short- and medium-term wear rates. However, the long-term wear characteristics are unknown and it is unclear whether reduced wear particle burden improves function and survival of cemented hip arthroplasty.

Questions/purposes

We asked whether XLPE wear rates remain low up to 10 years and whether this leads to improved implant fixation, periprosthetic bone quality, and clinical function compared to conventional PE.

Methods

We randomized 60 patients (61 hips) to receive either PE or XLPE cemented cups combined with a cemented stem. At 10 years postoperatively, 51 patients (52 hips) were evaluated for polyethylene wear and component migration estimation by radiostereometry, for radiolucent lines, bone densitometry, and Harris hip and pain scores. Revisions were recorded.

Results

XLPE cups had a lower mean three-dimensional wear rate between 2 and 10 years compared to conventional PE hips: 0.005 mm/year versus 0.056 mm/year. We found no differences in cup migration, bone mineral density, radiolucencies, functional scores, and revision rate. There was a trend toward improved stem fixation in the XLPE group. The overall stem failure rate was comparably high, without influencing wear rate in XLPE hips.

Conclusions

XLPE displayed a low wear rate up to 10 years when used in cemented THA, but we found no clear benefits in any other parameters. Further research is needed to determine whether cemented THA designs with XLPE are less prone to stem loosening.

Level of Evidence

Level I, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.

Available only for authorised users

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Title: Highly Crosslinked Polyethylene Does Not Reduce Aseptic Loosening in Cemented THA 10-year Findings of a Randomized Study
Authors: Per-Erik Johanson, MD
Georgios Digas, MD, PhD
Peter Herberts, MD, PhD
Jonas Thanner, MD, PhD
Johan Kärrholm, MD, PhD
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 11/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2400-x

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Highly Crosslinked Polyethylene Does Not Reduce Aseptic Loosening in Cemented THA 10-year Findings of a Randomized Study

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

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