Wear, Osteolysis, and Aseptic Loosening Following Total Hip Arthroplasty in Young Patients with Highly Cross-Linked Polyethylene: A Review of Studies with a Follow-Up of over 15 Years

Overview

Journal J Clin Med

Specialty General Medicine

Date 2023 Oct 28

PMID 37892754

Authors

Christopher F Deans

Brandt C Buckner

Kevin L Garvin

Affiliations

Soon will be listed here.

Abstract

Total hip arthroplasty (THA) has in recent years trended toward a younger, more physically demanding patient population. Mid- to long-term studies of all ages of THA patients using highly cross-linked polyethylene (HXLPE) have been favorable, but concerns about its long-term failure and wear-related complications remain for young THA patients. In this narrative review, a search of the PubMed/MEDLINE and Cochrane databases was performed, and we identified six studies with a minimum 15-year follow-up of HXLPE with various femoral head materials. Wear-related revisions were exceedingly low for patients under the age of 55, with variable reports of non-clinically significant osteolysis. Higher activity levels, a larger femoral head size, and femoral head material were not associated with greater long-term wear rates. Young THA with metal or ceramic on HXLPE is exceedingly durable with favorable outcomes at follow-ups of over 15 years.

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References

Choudhury D, Vrbka M, Mamat A, Stavness I, Roy C, Mootanah R . The impact of surface and geometry on coefficient of friction of artificial hip joints. J Mech Behav Biomed Mater. 2017; 72:192-199. DOI: 10.1016/j.jmbbm.2017.05.011. View

Garcia-Rey E, Garcia-Cimbrelo E, Cruz-Pardos A . New polyethylenes in total hip replacement: A ten- to 12-year follow-up study. Bone Joint J. 2013; 95-B(3):326-32. DOI: 10.1302/0301-620X.95B3.29456. View

Lang J, Whiddon D, Smith E, Salyapongse A . Use of ceramics in total hip replacement. J Surg Orthop Adv. 2008; 17(1):51-7. View

Hennessy D, Callaghan J, Liu S . Second-generation extensively porous-coated THA stems at minimum 10-year followup. Clin Orthop Relat Res. 2009; 467(9):2290-6. PMC: 2866944. DOI: 10.1007/s11999-009-0831-9. View

Waewsawangwong W, Goodman S . Unexpected failure of highly cross-linked polyethylene acetabular liner. J Arthroplasty. 2011; 27(2):323.e1-4. DOI: 10.1016/j.arth.2011.04.010. View

Roedel G, Kildow B, Sveom D, Garvin K . Total hip arthroplasty using highly cross-linked polyethylene in patients aged 50 years and younger : minimum 15-year follow-up. Bone Joint J. 2021; 103-B(7 Supple B):78-83. DOI: 10.1302/0301-620X.103B7.BJJ-2020-2443.R1. View

Nebergall A, Greene M, Rubash H, Malchau H, Troelsen A, Rolfson O . Thirteen-Year Evaluation of Highly Cross-Linked Polyethylene Articulating With Either 28-mm or 36-mm Femoral Heads Using Radiostereometric Analysis and Computerized Tomography. J Arthroplasty. 2016; 31(9 Suppl):269-76. DOI: 10.1016/j.arth.2016.02.076. View

Meneghini R, Lovro L, Wallace J, Ziemba-Davis M . Large Metal Heads and Vitamin E Polyethylene Increase Frictional Torque in Total Hip Arthroplasty. J Arthroplasty. 2015; 31(3):710-4. DOI: 10.1016/j.arth.2015.09.020. View

Wahl P, Mossu-Haas C, Dommann-Scherrer C, Wei K, Eschbach L, Gehr P . Early failure of a highly cross-linked polyethylene inlay after total hip arthroplasty probably due to insufficient irradiation. Proc Inst Mech Eng H. 2022; 236(12):1711-1719. DOI: 10.1177/09544119221130673. View

10.

Prock-Gibbs H, Pumilia C, Meckmongkol T, Lovejoy J, Mumith A, Coathup M . Incidence of Osteolysis and Aseptic Loosening Following Metal-on-Highly Cross-Linked Polyethylene Hip Arthroplasty: A Systematic Review of Studies with Up to 15-Year Follow-up. J Bone Joint Surg Am. 2021; 103(8):728-740. DOI: 10.2106/JBJS.20.01086. View

11.

Broomfield J, Malak T, Thomas G, Palmer A, Taylor A, Glyn-Jones S . The Relationship Between Polyethylene Wear and Periprosthetic Osteolysis in Total Hip Arthroplasty at 12 Years in a Randomized Controlled Trial Cohort. J Arthroplasty. 2016; 32(4):1186-1191. DOI: 10.1016/j.arth.2016.10.037. View

12.

Wan Z, Dorr L . Natural history of femoral focal osteolysis with proximal ingrowth smooth stem implant. J Arthroplasty. 1996; 11(6):718-25. DOI: 10.1016/s0883-5403(96)80011-8. View

13.

Bryan A, Calkins T, Karas V, Culvern C, Nam D, Della Valle C . Primary Total Hip Arthroplasty in Patients Less Than 50 Years of Age at a Mean of 16 Years: Highly Crosslinked Polyethylene Significantly Reduces the Risk of Revision. J Arthroplasty. 2019; 34(7S):S238-S241. DOI: 10.1016/j.arth.2019.02.025. View

14.

Alshammari M, De Petrillo G, Epure L, Huk O, Zukor D, Antoniou J . Outcomes of Ceramic-On-Ceramic Bearing Total Hip Arthroplasty: A Minimum 10-Year Follow-Up Study. J Arthroplasty. 2023; 38(7S):S146-S151. DOI: 10.1016/j.arth.2023.04.018. View

15.

DeLee J, CHARNLEY J . Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res. 1976; (121):20-32. View

16.

Jacquot L, Machenaud A, Bonnin M, Chouteau J, Vidalain J . Survival and Clinical Outcomes at 30 to 35 Years Following Primary Total Hip Arthroplasty With a Cementless Femoral Stem Fully Coated With Hydroxyapatite. J Arthroplasty. 2022; 38(5):880-885. DOI: 10.1016/j.arth.2022.11.016. View

17.

Rames R, Hillen T, Pashos G, Maloney W, Clohisy J . Incidence and Characteristics of Osteolysis in HXLPE THA at 16-Year Follow up in Patients 50 Years and Less. J Arthroplasty. 2020; 36(2):641-646. DOI: 10.1016/j.arth.2020.08.048. View

18.

Lachiewicz P, Soileau E, Martell J . Wear and Osteolysis of Highly Crosslinked Polyethylene at 10 to 14 Years: The Effect of Femoral Head Size. Clin Orthop Relat Res. 2015; 474(2):365-71. PMC: 4709306. DOI: 10.1007/s11999-015-4319-5. View

19.

Rames R, Stambough J, Pashos G, Maloney W, Martell J, Clohisy J . Fifteen-Year Results of Total Hip Arthroplasty With Cobalt-Chromium Femoral Heads on Highly Cross-Linked Polyethylene in Patients 50 Years and Less. J Arthroplasty. 2019; 34(6):1143-1149. DOI: 10.1016/j.arth.2019.01.071. View

20.

Harris W . The problem is osteolysis. Clin Orthop Relat Res. 1995; (311):46-53. View