Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep 9:11:140-145.
doi: 10.1016/j.artd.2021.08.002. eCollection 2021 Oct.

Sequentially Irradiated and Annealed Highly Cross-Linked Polyethylene: Linear Vector and Volumetric Wear in Total Hip Arthroplasty at 10 Years

Ethan A Remily  1 , Scott J Douglas  1 , Oliver C Sax  1 , Sahir S Pervaiz  1 , Nequesha S Mohamed  1 , Wayne A Wilkie  1 , Langan S Smith  2 , James Nace  1 , Arthur L Malkani  2 , Charles E Jaggard  3 , Frank R Kolisek  3 , Ronald E Delanois  1
Affiliations

Sequentially Irradiated and Annealed Highly Cross-Linked Polyethylene: Linear Vector and Volumetric Wear in Total Hip Arthroplasty at 10 Years

Ethan A Remily et al. Arthroplast Today. .

Abstract

Background: There is a paucity of data on the long-term performance of highly cross-linked polyethylene (HXLPE). Therefore, this study evaluated 10-year 1) functional, 2) radiographic, and 3) surgical outcomes in patients who underwent total hip arthroplasty with sequentially irradiated and annealed HXLPE.

Methods: A retrospective, multicenter study was conducted on patients who underwent primary total hip arthroplasty and received HXLPE polymer (n = 151). Two-dimensional radiographic linear and volumetric wear analyses were quantified using the Martell Hip Analysis software, while functional outcomes were assessed by analyzing postoperative Short-Form-12 (SF-12) Physical and Mental Health Surveys and Harris Hip Scores. Radiographic outcomes included yearly linear (mm/y) and volumetric (mm3/y) wear rates. Surgical outcomes included additional operations and survivorship.

Results: SF-12 scores were within 1 standard deviation (SD) of the normal population (SF-12 Physical: 47.0; SF-12 Mental: 52.0), while the Harris Hip Scores of 89.5 was borderline between "good" and "excellent." Total and annual linear wear rates were 0.164 mm (SD: 0.199 mm) and 0.015 mm/y (SD: 0.018 mm/y), respectively. The mean total volumetric wear rate was 141.4 mm3 (SD: 165.0) and 12.6 mm3/y (SD: 14.9 mm3/y) when broken down into a yearly rate. Eleven patients required revisions, resulting in an all-cause polyethylene survivorship of 92.7%, with a polyethylene wear survivorship of 100.0%.

Conclusions: Our results demonstrate clinically undetectable linear and volumetric wear rates after 10 years in those who received the unique sequentially irradiated and annealed HXLPE. Furthermore, high rates of survivorship coupled with low all-cause revision rates illustrate the polymers' capability to potentially increase implant longevity.

Keywords: Arthroplasty; Functional; HXLPE; Survivorship; THA; Wear.

PubMed Disclaimer

Figures

Figure 1
Figure 1
An illustration of the Martell Hip Analysis Suite software.
Figure 2
Figure 2
Kaplan-Meier survivorship plot of total hip arthroplasties receiving highly cross-linked polyethylene.
See this image and copyright information in PMC

References

    1. Gulland A. Global life expectancy increases by five years. BMJ. 2016;353:i2883. - PubMed
    1. Ardestani M.M., Amenábar Edwards P.P., Wimmer M.A. Prediction of polyethylene wear rates from gait biomechanics and implant positioning in total hip replacement. Clin Orthop Relat Res. 2017;475:2027. - PMC - PubMed
    1. Sakalkale D.P., Sharkey P.F., Eng K., Hozack W.J., Rothman R.H. Effect of femoral component offset on polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res. 2001:125. - PubMed
    1. Takenaga R.K., Callaghan J.J., Bedard N.A., Liu S.S., Gao Y. Which functional assessments predict long-term wear after total hip arthroplasty? Clin Orthop Relat Res. 2013;471:2586. - PMC - PubMed
    1. Greenwald A.S., Bauer T.W., Ries M.D. Committee on biomedical engineering, committee on hip and knee arthritis. New polys for old: contribution or caveat? J Bone Joint Surg Am. 2001;83-A(2):27. - PubMed

LinkOut - more resources