Increase in early polyethylene wear after sterilization with ethylene oxide -: Radiostereometric analyses of 201 total hips
Increase in early polyethylene wear after sterilization with ethylene oxide -: Radiostereometric analyses of 201 total hips
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DOI：
10.1080/00016470310017910
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发表时间：
2003-10-01
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影响因子：
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通讯作者：
Kärrholm, J
中科院分区：
文献类型：
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作者：
Digas, G;Thanner, J;Kärrholm, J
我们通过测量201例THA（中位年龄62（3141）岁，117名女性）的股骨头穿透来评估聚乙烯磨损，这些患者来自5项旨在评估不同固定原则的随机研究。有30个胶结的全聚乙烯Lubinus杯在还原氧环境中通过伽马辐射消毒，65个多孔涂层的Trilogy杯在惰性气体中进行伽马消毒。此外，37个胶结杯用环氧乙烷（反射全聚）消毒，69个多孔涂层杯的衬里用环氧乙烷（反射）消毒。所有杯子使用28个修女股骨头。对患者进行了长达2年的反复放射立体测量（RSA）。通过问卷调查评估患者的活动水平。2年后，EtO灭菌聚乙烯杯的近端和三维穿透率几乎是γ灭菌聚乙烯杯的两倍。穿透在不同的伽玛辐照设计之间没有差别。通过逐步线性回归分析，我们发现灭菌类型、年龄和体重是最重要的预测因子，它们决定了近端渗透率的方向。活动评分、男性性别和杯的近端移动影响不大。eto灭菌聚乙烯的加速磨损引起了长期问题，特别是在年轻患者中。
We evaluated polyethylene wear by measuring femoral head penetration in 201 THA (median age 62 (3141) years, 117 women) extracted from 5 randomized studies aimed to assess various fixation principles. There were 30 cemented all-polyethylene Lubinus cups sterilized by gamma irradiation in a reduced oxygen environment, 65 porous-coated Trilogy cups with liners gamma-sterilized in inert gas. Moreover, 37 cemented cups were sterilized with ethylene oxide (Reflection all-poly) and 69 porous-coated cups had liners sterilized in ethylene oxide (Reflection). 28 nun femoral heads were used in all cups. The patients were followed with repeated radiostereometric measurements (RSA) up to 2 years. The activity level of the patients was evaluated by a questionnaire.After 2 years, cups with polyethylene sterilized in EtO had almost twice the proximal and 3D penetration rates, as compared with gamma-sterilized polyethylene. The penetration did not differ between the gamma-irradiated designs. Using stepwise linear regression analysis, we found that the type of sterilization, age and weight were the most important predictors and that they determined the direction of the proximal penetration rate. Activity score, male gender and proximal migration of the cup had little effect. The accelerated wear observed with the EtO-sterilized polyethylene causes concerns about long-term problems and especially in younger patients.