Dual mobility retentive acetabular liners and wear: Surface analysis of 40 retrieved polyethylene implants
Dual mobility retentive acetabular liners and wear: Surface analysis of 40 retrieved polyethylene implants
复制标题
DOI：
10.1016/j.otsr.2013.12.011
复制
发表时间：
2014-02-01
影响因子：
2.3
通讯作者：
Fessy, M. -H.
中科院分区：
文献类型：
--
作者：
Adam, P.;Farizon, F.;Fessy, M. -H.
研究目的：自1976年以来，带固位型髋臼内衬的双动系统已用于全髋关节置换术的临床实践。双移动系统在提供更大稳定性的同时保持了更大的运动范围。本研究测量了40检索聚乙烯衬垫的凹凸表面上的磨损，以评估该系统的优势，在wear.Material和方法：四十聚乙烯插入已被删除，由于感染或机械故障后，平均8年进行了分析。关节成形术患者的平均年龄为46岁。宏观分析之后进行表面分析，直接测量曲率半径的变化。使用4 mm触针（BNH 706）在三维中测量内凹面。通过侧位投影测量外凸度。两种测量方法的估计误差为+/- 5 μ m。制造商对这些植入物的公差约为50 μ m。线性磨损和磨损体积通过比较新liners.Results的理论尺寸的测量尺寸确定：宏观上，所有的研究件已经失去了凸表面上的初始加工槽; 40%的件显示出明显的磨损固位衣领。平均年凸面磨损为9 μ m（SD 9 μ m），凹面磨损为73 μ m（SD 69 μ m）。平均总磨损（凸面和凹面磨损的总和）为82 μ m（SD 72 μ m）。凸面的磨损量为28.9 mm（3）/年（SD 27.6），凹面的磨损量为25.5 mm（SD 23.2），平均年总磨损量为54.3 mm（3）/年（SD 39.6）。讨论：在体内发挥作用的40件双动内衬的总磨损量与22.2 mm股骨头的金属-聚乙烯关节面的总磨损量相似。在凸和凹表面的磨损的结果表明，磨损与双移动系统相比，传统的金属-聚乙烯轴承没有增加，同时提供更好的保留和更大的stability.Conclusion：使用双移动髋臼内衬是一个有吸引力的解决方案时，金属-聚乙烯轴承是必要的。关节稳定性增加与磨损增加无关。(C)2013年由Elsevier Masson SAS出版。
Purpose of the study: Dual mobility systems with retentive acetabular liners have been used in clinical practice for total hip arthroplasty since 1976. The dual mobility system preserves a wide range of motion while providing greater stability. This study measured wear on the concave and convex surfaces of 40 retrieved polyethylene liners, to evaluate the advantages of this system in relation to wear.Material and methods: Forty polyethylene inserts that had been removed due to infection or mechanical failure after a mean 8 years were analyzed. The mean age of patients at arthroplasty was 46 years old. Macroscopic analysis was followed by surface analysis with direct measurement of changes in the curvature radii. The internal concave surface was measured in three dimensions using a 4-mm stylus (BNH 706). External convexity was measured by lateral projection. The estimated error was +/- 5 mu m for both measurement methods. Manufacturers' tolerance for these implants was approximately 50 mu m. Linear wear and wear volume was determined by comparing the measured dimensions with the theoretical dimensions of new liners.Results: Macroscopically, all of the pieces studied had lost the initial machined grooves on the convex surface; 40% of the pieces showed visible wear of the retentive collar. Mean annual convex surface wear was 9 mu m (SD 9 mu m) and 73 mu m (SD 69 mu m) for the concave surface. Mean total wear, which was the sum of the wear on the convex and concave surfaces was 82 mu m (SD 72 mu m). Wear volume was 28.9 mm(3)/yr for the convex surface (SD 27.6) and 25.5 for the concave surface (SD 23.2) with a mean annual total wear volume of 54.3 mm(3)/yr (SD 39.6).Discussion: Total wear in the 40 dual mobility liners that had functioned in vivo was similar to that reported in metal-polyethylene bearings with 22.2 mm femoral heads. The results of wear in both the convex and concave surfaces show that wear with the dual mobility system was not increased compared to conventional metal-polyethylene bearings, while providing better retention and greater stability.Conclusion: The use of dual mobility acetabular liners is an attractive solution when a metal-polyethylene bearing is needed. The increased joint stability is not associated with increased wear. (C) 2013 Published by Elsevier Masson SAS.