Wear rate and osteolysis in two types of second-generation annealed highly cross-linked polyethylene in total hip arthroplasty: A retrospective comparative study with a minimum of five years
Wear rate and osteolysis in two types of second-generation annealed highly cross-linked polyethylene in total hip arthroplasty: A retrospective comparative study with a minimum of five years
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两种第二代退火高交联聚乙烯在全髋关节置换术中的磨损率和骨质溶解：至少五年的回顾性比较研究
DOI：
10.1016/j.otsr.2021.103147
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Okawa Atsushi
中科院分区：
文献类型：
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作者：
Yamamoto Naoki;Takada Ryohei;Jinno Tetsuya;Miyatake Kazumasa;Watanabe Naoto;Koga Hideyuki;Yoshii Toshitaka;Yagishita Kazuyoshi;Okawa Atsushi
背景由于之前没有研究直接比较两种类型的第二代退火高交联聚乙烯的线性磨损率，我们进行了一项回顾性研究，至少随访5年，以评估初次关节置换术的（1）磨损率和（2）假设两种HXLPE的线性磨损率和骨溶解发生率无显著差异患者和方法在这项单中心研究中，我们回顾了2011年至2015年期间257例初次非骨水泥型全髋关节置换术，这些手术在第二代退火高交联聚乙烯上使用32 mm delta陶瓷进行（X3和E1分别用于105例和103例。）。平均磨损率进行了评估，使用计算机辅助的方法，骨质溶解的发生率进行了评估的基础上出现的局部区域与损失的骨小梁或皮质侵蚀相邻的implants.ResultsIn总，我们评估了208例，术后超过5年（平均值，6.1年，范围：5.0 - 8.0）。在年龄方面，两组之间没有显著差异（按X组、E组、p值顺序列出）（61.2 ± 12.3，62.7 ± 12.1，p = 0.36），性别（男性比例：17.1%，14.6%，p = 0.61），体重指数（22.9 ± 3.7，22.8 ± 4.0，p = 0.91），术前（49.9 ± 14.8，48.5 ± 13.8，p = 0.49）和术后（91.3 ± 9.1，92.7 ± 7.0，p = 0.23）日本骨科协会髋关节评分，髋臼杯尺寸髋臼杯倾角（38.7 ± 4.8，37.6 ± 4.8，p = 0.10）和髋臼杯前倾（18.7 ± 6.9，18.5 ± 7.6，p = 0.80）。X3和E1组的平均线性磨损率分别为0.057 ± 0.039（范围：0 - 0.16）和0.054 ± 0.037 mm/年（范围：0 - 0.15）（p = 0.61）。没有骨质溶解被发现在两个groups.DiscussionThis研究表明，这两种类型的高度交联聚乙烯具有良好的线性磨损率，并同样安全使用的最终平片。然而，两种材料在长期磨损率方面的差异还有待进一步验证。证据等级III;回顾性病例对照研究。
BackgroundAs no previous study has directly compared the linear wear rate in two types of second-generation annealed highly cross-linked polyethylene, we performed a retrospective study with a minimum of 5-year follow-up to assess primary arthroplasties in the (1) wear rates and (2) incidence of osteolysis of the two types of HXLPE.HypothesisThere was no significant difference in the linear wear rate and the incidence of osteolysis between the two types of second-generation annealed highly cross-linked polyethylene.Patients and methodsIn this single-center study, we reviewed 257 cases of primary cementless total hip arthroplasties between 2011 and 2015, which were performed with 32 mm delta ceramic on second-generation annealed highly cross-linked polyethylene (X3 and E1 were used in 105 and 103 cases, respectively.). The mean wear rate was evaluated using a computer-assisted method, and the incidence of osteolysis was evaluated based on the appearance of a localized area with loss of trabecular bone or cortical erosion adjacent to the implants during the latest follow-up.ResultsIn total, we evaluated 208 cases, followed postoperatively for over 5 years (mean, 6.1 years, range: 5.0-8.0). There were no significant differences between the two groups with respect to age (list in order of Group X, Group E,pvalue) (61.2 ± 12.3, 62.7 ± 12.1,p= 0.36), sex (ratio of male: 17.1%, 14.6%,p= 0.61), body mass index (22.9 ± 3.7, 22.8 ± 4.0,p= 0.91), pre- (49.9 ± 14.8, 48.5 ± 13.8,p= 0.49) and post-operative (91.3 ± 9.1, 92.7 ± 7.0,p= 0.23) Japanese Orthopaedic Association Hip Score, cup size (50.8 ± 3.0, 50.9 ± 2.2,p= 0.70), cup inclination (38.7 ± 4.8, 37.6 ± 4.8,p= 0.10), and cup anteversion (18.7 ± 6.9, 18.5 ± 7.6,p= 0.80). The mean linear wear rates of the X3 and E1 groups were 0.057 ± 0.039 (range: 0–0.16) and 0.054 ± 0.037 mm/year (range: 0–0.15), respectively (p= 0.61). No osteolysis was found on the final plain radiographs in both groups.DiscussionThis study revealed that both types of highly cross-linked polyethylene have excellent linear wear rates and were equally safe to use. However, the difference between the two materials in terms of the long-term wear rate should be further validated.Level of evidenceIII; retrospective case control study.