The Journal of Bone and Joint Surgery (American) 86:748-751 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.
Short-Term in Vivo Wear of Cross-Linked Polyethylene
Christian Heisel, MD1,
Mauricio Silva, MD1,
Mylene A. dela Rosa, BS1 and
Thomas P. Schmalzried, MD1
1 Joint Replacement Institute at Orthopaedic Hospital, 2400 South Flower Street,
Los Angeles, CA 90007
Investigation performed at the Joint Replacement Institute at
Orthopaedic Hospital, Los Angeles, California
In support of their research or preparation of this manuscript, one or more
of the authors received grants or outside funding from the Piedmont Fund of
the Los Angeles Orthopaedic Hospital Foundation. In addition, one or more of
the authors received payments or other benefits or a commitment or agreement
to provide such benefits from a commercial entity (DePuy, a Johnson and
Johnson Company). No commercial entity paid or directed, or agreed to pay or
direct, any benefits to any research fund, foundation, educational
institution, or other charitable or nonprofit organization with which the
authors are affiliated or associated.
A commentary is available with the electronic versions of this article,
on our web site (www.jbjs.org) and on our quarterly CD-ROM (call our
subscription department, at 781-449-9780, to order the CD-ROM).
Background: Cross-linked polyethylene was developed to reduce
volumetric wear in prosthetic joints. Hip simulator studies have shown
promising results with regard to wear reduction. This study evaluated the
short-term in vivo wear of a moderately cross-linked polyethylene.
Methods: Linear head penetration, as an assessment of in vivo
polyethylene wear, was measured in two groups of patients after total hip
replacement. Twenty-four hips received a conventional polyethylene insert and
thirty-four, a cross-linked polyethylene liner; both inserts were manufactured
by the same company. Linear and volumetric wear rates were measured on
radiographs with use of a validated computer-assisted technique and were
adjusted for patient-related factors. Patient activity was assessed by a
computerized two-dimensional accelerometer worn on the ankle.
Results: Patients with a conventional polyethylene insert showed a
mean linear wear rate of 0.13 mm per year and a mean volumetric wear rate of
87.6 mm3 per year. The group with a cross-linked polyethylene liner
showed a mean linear wear rate of 0.02 mm per year and a mean volumetric wear
rate of 17.0 mm3 per year. Wear in the group with cross-linked
polyethylene was 81% lower than that in the group with conventional
polyethylene (p < 0.00001). Accounting for differences in patient activity,
the adjusted wear rates per million cycles for a patient weight of 70 kg were
53 mm3 per million cycles for conventional polyethylene and 15
mm3 per million cycles for cross-linked polyethylene, a 72%
reduction (p = 0.0002). No factor, other than the type of polyethylene, was
found to influence the difference in wear rates between the two groups.
Conclusions: The results of this study are promising. The in vivo
wear reduction with this cross-linked polyethylene is consistent with the
predictions of hip simulator studies.
Level of Evidence: Therapeutic study, Level II-1
(prospective cohort study). See Instructions to Authors for a complete
description of levels of evidence.
 CiteULike  Connotea  Del.icio.us  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
R. G. Bitsch, T. Loidolt, C. Heisel, S. Ball, and T. P. Schmalzried
Reduction of Osteolysis with Use of Marathon Cross-Linked Polyethylene. A Concise Follow-up, at a Minimum of Five Years, of a Previous Report
J. Bone Joint Surg. Am.,
July 1, 2008;
90(7):
1487 - 1491.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. J. Callaghan, J. M. Cuckler, J. I. Huddleston, and J. O. Galante
How have alternative bearings (such as metal-on-metal, highly cross-linked polyethylene, and ceramic-on-ceramic) affected the prevention and treatment of osteolysis?
J. Am. Acad. Ortho. Surg.,
July 1, 2008;
16(suppl_1):
S33 - S38.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S.-H. Baek and S.-Y. Kim
Cementless Total Hip Arthroplasty with Alumina Bearings in Patients Younger Than Fifty with Femoral Head Osteonecrosis
J. Bone Joint Surg. Am.,
June 1, 2008;
90(6):
1314 - 1320.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. G. Bitsch, M. Zamorano, T. Loidolt, C. Heisel, J. J. Jacobs, and T. P. Schmalzried
Ion Production and Excretion in a Patient with a Metal-on-Metal Bearing Hip Prosthesis. A Case Report
J. Bone Joint Surg. Am.,
December 1, 2007;
89(12):
2758 - 2763.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. A. Jacobs, C. P. Christensen, A. S. Greenwald, and H. McKellop
Clinical Performance of Highly Cross-Linked Polyethylenes in Total Hip Arthroplasty
J. Bone Joint Surg. Am.,
December 1, 2007;
89(12):
2779 - 2786.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Furmanski, S. Gupta, A. Chawan, A. Kohm, J. Lannutti, B. Jewett, L. A. Pruitt, and M. D. Ries
Aspherical Femoral Head with Highly Cross-Linked Ultra-High Molecular Weight Polyethylene Surface Cracking. A Case Report
J. Bone Joint Surg. Am.,
October 1, 2007;
89(10):
2266 - 2270.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. C. Gordon, D. D. D'Lima, and C. W. Colwell Jr
Highly Cross-linked Polyethylene in Total Hip Arthroplasty.
J. Am. Acad. Ortho. Surg.,
September 1, 2006;
14(9):
511 - 523.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. J. Bozic, S. Morshed, M. D. Silverstein, H. E. Rubash, and J. G. Kahn
Use of Cost-Effectiveness Analysis to Evaluate New Technologies in Orthopaedics. The Case of Alternative Bearing Surfaces in Total Hip Arthroplasty
J. Bone Joint Surg. Am.,
April 1, 2006;
88(4):
706 - 714.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. W. McCalden, D. D. Naudie, X. Yuan, and R. B. Bourne
Radiographic Methods for the Assessment of Polyethylene Wear After Total Hip Arthroplasty
J. Bone Joint Surg. Am.,
October 1, 2005;
87(10):
2323 - 2334.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. H. Huo and M. S. Muller
What's New in Hip Arthroplasty
J. Bone Joint Surg. Am.,
October 1, 2004;
86(10):
2341 - 2353.
[Full Text]
[PDF]
|
|
|
Letters to the Editor:
Read all Letters to the Editor
- Short Term in vivo Wear vs. Creep
- William H. Harris, M.D.
- JBJS Online, 26 May 2004
[Full text]
|
