Polyethylene thickness does not influence aseptic revision rate with highly cross-linked liners in THA with 36-mm femoral heads.

IF 1.3 4区医学 Q3 ORTHOPEDICS

HIP International Pub Date : 2024-03-01 Epub Date: 2023-09-03 DOI:10.1177/11207000231196141

Willem R Six, Iris Koenraadt-van Oost, Leonieke C van Boekel, Stefan B T Bolder

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引用次数: 0

Abstract

Background: To reduce the risk of dislocation, larger head size can be used in total hip arthroplasty (THA). However, larger head size leads to thinner acetabular liners. With conventional polyethylene, thickness of >8 mm has been advocated to reduce stress and wear rate of the polyethylene. Modern polyethylene has become more wear-resistant. In this study, we investigated if the thickness of sequentially cross-linked polyethylene (XLPE) liners is associated with failure of THA in the medium term.

Patients and methods: 3654 THAs were included (2009-2016), in which THA was performed with a XLPE liner in combination with a 36-mm femoral head. Patient and surgical characteristics were collected. We compared implant survival of THA with thin liners (<7.9 mm) and thick liners (⩾7.9 mm) with a Kaplan Meier survival analysis at 5 years, median follow-up and 10 years of follow-up with and point aseptic loosening and performed a multivariate analysis to estimate hazard ratios (HR).

Results: Median follow-up was 7.7 years (IQR 5.6-9.8). In total, 179 revision procedures were performed, where 82 revisions (46%) were performed for aseptic loosening. The survival rate at 5 years, median and 10 years of follow-up showed no statistically significant difference in implant survival. The survival rate at 10 years follow-up was for thin liners 97.1% (95% CI, 96.3-97.9) and for thick liners 98.2% (95% CI, 97.4-99.0) in the aseptic loosening group (chi-square 2.55; p = 0.11).The adjusted HR for thick liners (⩾7.9 mm) was 0.65 (95% CI, 0.38-1.08) compared with the thin liners (<7.9 mm), which was not significantly different.

Conclusions: From this single-centre retrospective study it appears that thinner polyethylene liners are well tolerated when using second-generation highly cross-linked polyethylene. Thickness of the XLPE liners did not influence the risk of aseptic loosening of the implants in the medium term.

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在使用 36 毫米股骨头的 THA 中，聚乙烯厚度不会影响高交联内衬的无菌翻修率。

背景：为降低脱位风险，在全髋关节置换术（THA）中可使用较大的髋臼头。然而，较大的头部尺寸会导致髋臼衬垫变薄。对于传统的聚乙烯，人们主张厚度大于 8 毫米，以减少聚乙烯的应力和磨损率。现代聚乙烯已变得更加耐磨。在这项研究中，我们调查了序列交联聚乙烯（XLPE）衬垫的厚度是否与 THA 的中期失败有关。患者和方法：共纳入了 3654 例 THA（2009-2016 年），其中使用 XLPE 衬垫结合 36 毫米股骨头进行了 THA。我们收集了患者和手术特征。我们比较了使用薄衬垫的 THA 植入物的存活率（结果：中位随访时间为 7.7 年：中位随访时间为 7.7 年（IQR 5.6-9.8）。总共进行了 179 例翻修手术，其中 82 例（46%）因无菌性松动而翻修。随访5年、中位数和10年的存活率显示，植入物存活率在统计学上没有显著差异。在无菌性松动组中，薄衬垫（⩾7.9 mm）和厚衬垫（⩾7.9 mm）的随访10年存活率分别为97.1%（95% CI，96.3-97.9）和98.2%（95% CI，97.4-99.0）（秩方2.55；P = 0.11）：从这项单中心回顾性研究中可以看出，在使用第二代高交联聚乙烯时，较薄的聚乙烯内衬具有良好的耐受性。从中期来看，XLPE 内衬的厚度不会影响种植体无菌性松动的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIP International 医学-整形外科

CiteScore

4.20

自引率

0.00%

发文量

审稿时长

2 months

期刊介绍： HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology