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Alumina-on-HXLPE THA bearings show good long-term wear results
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Investigators performed bilateral simultaneous sequential cementless total hip arthroplasty with alumina-on-highly-crosslinked polyethylene and alumina-on-alumina ceramic bearings in 100 patients and compared the wear performance at a mean follow-up of about 12 years.
“Under the condition and duration of this study and in this specific group of young and active [patients], contemporary alumina-on-highly crosslinked polyethylene bearings [HXLPE] had excellent clinical and radiographical outcomes with no osteolysis. Longer follow-up is needed to evaluate how this procedure performs over a longer duration,” Young-Hoo Kim, MD, of Seoul, said at the American Academy of Orthopaedic Surgeons Annual Meeting.
Kim and colleagues compared the clinical and radiological results in the 200 hips and studied the osteolysis prevalence in these young and active patients. The mean follow up for the comparison was 12.4 years. The 66 men and 34 women had a mean age of 45.3 years at surgery. Follow-up assessments were done at 3 months, 1 year and annually thereafter.
“Our clinical follow up, including Harris hip score, WOMAC and UCLA activity score, and radiographic follow-up confirmed our findings,” he said.
The three scores did not show significant differences between the hips treated with the two types of bearings preoperatively or at the final follow-up. Radiographic findings were also not significantly different between the two groups of bearings, according to Kim.
“No hips in either group displayed osteolysis. The Kaplan-Meier survivorship with revision as the end point at 12.4 years was 100% (95% confidence interval [CI], 94% to 100%) for the femoral component in both groups and 99% (95% confidence interval [CI], 93% to 100%) for the acetabular component,” Kim and colleagues wrote.
In a few hips with the all ceramic prosthesis, Kim said the patients reported a squeaking noise during weight bearing at 3 years follow-up.
“Because the results of using an alumina-on-alumina ceramic and alumina-on-highly-crosslinked polyethylene bearings were similar at 12.4 years follow-up, alumina-on-highly-crosslinked polyethylene bearing could replace alumina-on-alumina ceramic to avoid potential squeaking or clicking sound and cup liner fracture,” Kim and colleagues wrote. – by Robert Linnehan
- Reference:
- Kim YH. Paper #243. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 11-15, 2014; New Orleans.
- For more information:
- Young-Hoo Kim, MD, can be reached at Ewha Womans University, Mokdong Hospital, The Joint Replacement Center of Korea #911-1, Mokdong, Yangchun-Ku, Seoul 158-710, Republic of Korea; email: younghookim@ewha.ac.kr.
Disclosure: Kim receives royalties from DePuy Synthes.