Primary ArthroplastyTen- to Sixteen-Year Follow-Up of Highly Cross-Linked Polyethylene in Total Hip Arthroplasty: What Factors Affect Wear?
Section snippets
Patients and Methods
This study received approval from the local institutional review board. From April 2001 to December 2007, a total of 230 total hip arthroplasties were performed in our institution. After excluding arthroplasties performed using other bearing couplings, brands of liner and different hip ball sizes, a total of 151 THAs performed using 28-mm hip balls and Marathon liners were left. After exclusion of those with inadequate radiological and clinical follow-up, the remaining cohort consisted of 93
Clinical Results
The mean duration of follow-up was 12.7 years (range: 10-16). The Harris Hip Score improved significantly from a mean of 46.02 before operation to a mean of 88.6 at the latest follow-up visit (P < .0001). The pain component of Harris Hip Score improved from a mean of 17.6 before operation to 43 at the latest follow-up visit (P < .0001). No patients complained of significant pain over the operated extremity which hindered their ability to ambulate.
One patient had aseptic loosening of the
Discussion
An important finding of this study is that there is a positive significant correlation between acetabular component abduction angle and linear wear rate of highly cross-linked liners over a long duration of follow-up. This relationship has been well established for conventional polyethylene liners [9], [10], [17]. Prior studies examining this in HXLPE with long-term follow-up have been unable to demonstrate a significant relationship between acetabular abduction angle and linear wear [12], [13]
Acknowledgments
The authors would like to thank Miss Bernice Leung, Miss Tegan Ho, Mr. Lison Fung and Miss Vivian Chan for their contributions in data collection and record retrieval.
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One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2019.04.041.