The Journal of Bone and Joint Surgery 78:1193-1200 (1996)
© 1996 The Journal of Bone and Joint Surgery, Inc.
Wear of Polyethylene Cups in Total Hip Arthroplasty. A Study of Specimens Retrieved Post Mortem*
CHRISTI J. SYCHTERZ, M.S.E. ,
KYOUNG H. MOON, M.D., PH.D., ARLINGTON,
YASHUSHI HASHIMOTO, M.D., PH.D. , CLEVELAND,
KEVIN M. TEREFENKO, M.D.,
C. ANDERSON ENGH, JR., , ARLINGTON, VIRGINIA and
THOMAS W. BAUER, M.D., PH.D., CLEVELAND, OHIO
Investigation performed at The Anderson Orthopaedic Research Institute, Arlington, and The Cleveland Clinic Foundation, Cleveland
The wear of polyethylene components of total hip replacements has previously been studied radiographically and by analysis of retrieved components. The extent of wear, however, has largely been determined from components retrieved at reoperation and has therefore been based on a subset of patients in whom the prosthesis is more likely to show excessive wear. The study of cups retrieved post mortem provides a better indication of the extent of wear of well functioning components.
Twenty-six polyethylene liners were retrieved at autopsy from nineteen patients, after a mean of ninety-one months (range, thirty-three to 206 months) in situ. Each component had articulated with a thirty-two-millimeter-diameter femoral head. The components were evaluated visually for evidence of polyethylene wear such as pitting, scratching, and burnishing. Additionally, a shadowgraph technique was used to examine molds of the inner surface of the liner to determine the direction and extent of wear.
The mean extent of linear wear of the retrieved liners was 0.45 millimeter (range, 0.17 to 1.07 millimeters), and the mean rate of wear was 0.07 millimeter (range, 0.02 to 0.18 millimeter) per year. The mean volumetric wear was 245.3 cubic millimeters (range, 13.0 to 779.1 cubic millimeters), and the mean rate of volumetric wear was 39.8 cubic millimeters (range, 1.0 to 131.3 cubic millimeters) per year. The mean rate of wear for the twenty-six liners was 45 to 69 per cent less than the rates reported in the literature for polyethylene liners retrieved at reoperation.
Examination of the articulating surface did not reveal gross evidence of surface failure such as delamination or fatigue cracks. In general, the surfaces were merely burnished and scratched. The rates of wear of press-fit, metal-backed liners were significantly higher than those of all-polyethylene cemented components (p < 0.05). Additionally, statistical analysis revealed no correlation between wear and the patient's age, weight, or gender; the duration of implantation; or the thickness of the polyethylene. These results indicate that wear of the polyethylene of well functioning hip replacements is not as excessive as reported previously.
 CiteULike  Connotea  Del.icio.us  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
D. W. Howie, S. D. Neale, R. Stamenkov, M. A. McGee, D. J. Taylor, and D. M. Findlay
Progression of Acetabular Periprosthetic Osteolytic Lesions Measured with Computed Tomography
J. Bone Joint Surg. Am.,
August 1, 2007;
89(8):
1818 - 1825.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Bradford, D. A. Baker, J. Graham, A. Chawan, M. D. Ries, and L. A. Pruitt
Wear and Surface Cracking in Early Retrieved Highly Cross-linked Polyethylene Acetabular Liners
J. Bone Joint Surg. Am.,
June 1, 2004;
86(6):
1271 - 1282.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. B. Collier, M. J. Kraay, C. M. Rimnac, and V. M. Goldberg
Evaluation of Contemporary Software Methods Used to Quantify Polyethylene Wear After Total Hip Arthroplasty
J. Bone Joint Surg. Am.,
December 1, 2003;
85(12):
2410 - 2418.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. Good, M. Ries, R. L. Barrack, K. Widding, G. Hunter, and D. Heuer
Reduced Wear with Oxidized Zirconium Femoral Heads
J. Bone Joint Surg. Am.,
November 1, 2003;
85(90004):
105 - 110.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. F. Orishimo, A. M. Claus, C. J. Sychterz, and C. A. Engh
Relationship Between Polyethylene Wear and Osteolysis in Hips witha Second-Generation Porous-Coated Cementless Cup After Seven Years of Follow-up
J. Bone Joint Surg. Am.,
May 28, 2003;
85(6):
1095 - 1099.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. F. Haft, A. D. Heiner, L. D. Dorr, T. D. Brown, and J. J. Callaghan
A Biomechanical Analysis of Polyethylene Liner Cementation into a Fixed Metal Acetabular Shell
J. Bone Joint Surg. Am.,
May 28, 2003;
85(6):
1100 - 1110.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. K. VAUGHN, T. B. DAMERON, T. W. BAUER, Y. MOCHIDA, T. AKISUE, and R. W. EBERLE
Early Osteolysis Following Total Hip Arthroplasty with Use of a Hylamer Liner in Combination with a Modular Ceramic Femoral Head. A Case Report
J. Bone Joint Surg. Am.,
October 1, 1999;
81(10):
1446 - 9.
[Full Text]
|
|
|
|
|
|
|
C. J. SYCHTERZ, C. A. ENGH, A. YANG, and C. A. ENGH
Analysis of Temporal Wear Patterns of Porous-Coated Acetabular Components: Distinguishing Between True Wear and So-Called Bedding-in
J. Bone Joint Surg. Am.,
June 1, 1999;
81(6):
821 - 30.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
M. B. PETERSEN, I. H. POULSEN, J. THOMSEN, and S. SOLGAARD
The Hemispherical Harris-Galante Acetabular Cup, Inserted without Cement. The Results of an Eight to Eleven-Year Follow-up of One Hundred and Sixty-Eight Hips
J. Bone Joint Surg. Am.,
February 1, 1999;
81(2):
219 - 24.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
T. P. SCHMALZRIED and J. J. CALLAGHAN
Current Concepts Review - Wear in Total Hip and Knee Replacements
J. Bone Joint Surg. Am.,
January 1, 1999;
81(1):
115 - 136.
[Full Text]
|
|
|
|
|
|
|
M. YAMAGUCHI, T. W. BAUER, and Y. HASHIMOTO
Three-Dimensional Analysis of Multiple Wear Vectors in Retrieved Acetabular Cups
J. Bone Joint Surg. Am.,
October 1, 1997;
79(10):
1539 - 44.
[Abstract]
[Full Text]
|
|
|
|
