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Highly cross-linked PE THA bearings used in younger patients may show reduced wear, lower risk of osteolysis
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LAS VEGAS — Younger patients who underwent total hip arthroplasty with a prosthesis that used highly cross-linked polyethylene bearings showed less bearing surface wear and a lower incidence of osteolysis than patients who received conventional polyethylene bearings, according to research presented at the American Academy of Orthopaedic Surgeons Annual Meeting.
“At 10-year average follow-up, there is excellent clinical improvement with 28 mm cobalt chrome heads for this young patient population,” Jeffrey B. Stambough, MD, said. “There is essentially undetectable linear and volumetric wear rates without lysis on X-ray.”
Stambough and colleagues retrospectively reviewed 122 hips in 115 patients who underwent total hip arthroplasty (THA) with highly cross-linked polyethylene (HXLPE) as a bearing surface and they reviewed another 112 hips in 97 patients who underwent THA with conventional polyethylene (PE).
The main diagnosis in both groups was osteoarthritis, and avascular necrosis was seen preoperatively in 36% of patients with HXLPE and 43% of patients with conventional PE.
The investigators assessed hip function with the UCLA and Harris Hip scores and determined the amount of polyethylene wear in each patient via a computer-assisted edge detection method. They found no radiographic evidence of osteolysis in the HXLPE group but observed osteolysis in 17 hips in the conventional PE group, Stambough reported.
The results of the study showed median PE wear after bedding in was 0.0109 mm annually in the HXLPE cohort and 0.129 mm annually in hips with conventional PE bearings, according to the results.
The respective failure rates in the HXLPE and conventional PE cohorts were 4.1% and 6.3%. Improvements from preoperative levels were reported for the UCLA scores (3.9 to 6.6 for HXLPE and 3.3 to 5.1 for conventional PE) and for the Harris Hip Scores (43.8 to 84.8 for HXLPE and 37.2 to 78.2 for conventional PE).
According to the findings, two hips needed revising in the HXLPE group for aseptic loosening (ASL) and one hip each in those patients were revised for femoral subsidence, heterotopic ossification and instability. Two hips in the conventional PE group were revised due to instability. Four hips were revised for ASL and one was revised for pain. — by Christian Ingram
Reference:
Bohnenkamp FC, et al. Paper #7. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2015; Las Vegas.
Disclosure: Stambough reports no relevant financial disclosures.