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Type: Journal article
Title: The wear rate of highly cross-linked polyethylene in total hip replacement is not increased by large articulations: a randomized controlled trial
Author: Howie, D.
Holubowycz, O.
Callary, S.
Citation: Journal of Bone & Joint Surgery - American, 2016; 98(21):1786-1793
Publisher: The Journal of Bone and Joint Surgery
Issue Date: 2016
ISSN: 0021-9355
Statement of
Donald W. Howie, Oksana T. Holubowycz, and Stuart A. Callary
Abstract: BACKGROUND: Larger articulations reduce the risk of dislocation following primary total hip arthroplasty, leading to increased use of these articulations. The wear rate of highly cross-linked polyethylene (XLPE) is low in standard-diameter articulations but remains unclear in larger articulations. The aim of this randomized controlled trial was to compare the mean wear rates of 36-mm and 28-mm metal-on-XLPE articulations between 1 and 3 years postoperatively. METHODS: Fifty-six elderly patients undergoing primary total hip arthroplasty were randomized intraoperatively to receive either a 36-mm or 28-mm metal-on-XLPE articulation. Factors that may affect wear were controlled by study design. Wear was measured using radiostereometric analysis. RESULTS: Mean annual proximal wear rates between 1 and 3 years were 0.00 and 0.01 mm/yr for the 36 and 28-mm articulation cohorts, respectively. No patient had a proximal wear rate of >0.1 mm/yr. Mean wear was very low in all directions, and the wear rate of 36-mm articulations was not significantly greater than that of 28-mm articulations on the basis of proximal, medial 2-dimensional, and 3-dimensional wear. CONCLUSIONS: The wear rate of a larger 36-mm metal-on-XLPE articulation between 1 and 3 years following primary total hip arthroplasty was low and no greater than that of a 28-mm articulation. However, before a 36-mm metal-on-XLPE articulation is widely recommended, particularly in young active patients, long-term wear rates and association between wear and periprosthetic osteolysis should be determined. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Keywords: Hip Joint; Humans; Osteoarthritis, Hip; Prosthesis Failure; Polyethylene; Treatment Outcome; Arthroplasty, Replacement, Hip; Prosthesis Design; Hip Prosthesis; Stress, Mechanical; Aged; Female; Male
Rights: Copyright © 2016 by The Journal Of Bone And Joint Surgery, Incorporated
RMID: 0030061083
DOI: 10.2106/JBJS.15.01248
Appears in Collections:Surgery publications

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