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Highly Cross-Linked Polyethylene in Total Hip Arthroplasty in Patients Younger Than 50 Years With Osteonecrosis of the Femoral Head: A Minimum of 10 Years of Follow-Up

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Affiliated Author(s)
민병우조철현손은석이경재이시욱송광순
Alternative Author(s)
Min, Byung WooCho, Chul HyunSon, Eun SeokLee, Kyung JaeLee, Si WookSong, Kwang Soon
Journal Title
Journal of arthroplasty
ISSN
1532-8406
Issued Date
2019
Keyword
osteonecrosisfemoral headtotal hip arthroplastyhighly cross-linked polyethylenewearosteolysis
Abstract
Background:
Polyethylene wear and subsequent periprosthetic osteolysis remain a major concern of total hip arthroplasty (THA) failure in young, active patients with osteonecrosis of the femoral head (ONFH). The literature is lacking regarding the long-term performance of highly cross-linked polyethylene (HXLPE) in these patients. The purpose of this study is to evaluate long-term results for cementless THA using metal-on-HXLPE bearing couplings in patients younger than 50 years with ONFH.

Methods:
We retrospectively evaluated the clinical and radiographic results of a consecutive series of 85 THAs (in 67 patients) performed with HXLPE liners (Durasul) in patients younger than 50 years who had ONFH. All procedures were performed at a single institution by a single surgeon using the same type of implants. The minimum duration of follow-up was 10 years (mean, 13.5 years; range, 10-17.3 years). Wear was measured using computer software. Osteolysis was evaluated with the use of radiography and computed tomography.

Results:
The mean Harris hip score was 49.3 points (range, 26-68 points) before surgery, which improved to 93.6 points (range, 87-98 points) after surgery. Neither femoral nor acetabular components displayed mechanical loosening, and no components had been revised by the final follow-up evaluation. Radiographs and computed tomography scans did not demonstrate osteolysis. The mean liner wear was 0.037 mm/y (range, 0-0.099 mm/y). With the data available, univariate regression analysis did not demonstrate that age, sex, weight, activity level, underlying cause of osteonecrosis, liner thickness, or cup inclination had any influence on liner penetration.

Conclusion:
Although the long-term effects of HXLPE particles remain unknown, the implant survivorship rate and wear rate in our study are promising and support the continued use of metal-on-HXLPE bearing couplings in these high-risk patients because they do not produce any of the issues associated with hard-on-hard couplings.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Department
Dept. of Orthopedic Surgery (정형외과학)
Publisher
School of Medicine (의과대학)
Citation
Byung-Woo Min et al. (2019). Highly Cross-Linked Polyethylene in Total Hip Arthroplasty in Patients Younger Than 50 Years With Osteonecrosis of the Femoral Head: A Minimum of 10 Years of Follow-Up. Journal of arthroplasty. doi: 10.1016/j.arth.2019.10.021
Type
Article
ISSN
1532-8406
DOI
10.1016/j.arth.2019.10.021
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42353
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학)
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