Reasons for Revision of First-Generation Highly Cross-Linked Polyethylenes


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Kurtz S. M., Medel F. J., MacDonald D. W., Parvizi J., Kraay M. J., Rimnac C. M.

JOURNAL OF ARTHROPLASTY, cilt.25, sa.6, ss.67-74, 2010 (SCI-Expanded) identifier identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 25 Sayı: 6
  • Basım Tarihi: 2010
  • Doi Numarası: 10.1016/j.arth.2010.04.018
  • Dergi Adı: JOURNAL OF ARTHROPLASTY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.67-74
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Hayır

Özet

Over a 10-year period, we prospectively evaluated the reasons for revision of contemporary and highly cross-linked polyethylene formulations in a multicenter retrieval program. Two hundred twelve consecutive retrievals were classified as conventional gamma inert sterilized (n = 37), annealed (Crossfire [Stryker Orthopedics, Mahwah, NJ], n = 72), or remelted (Longevity [Zimmer,Warsaw, Ind], XLPE [Smith and Nephew, Memphis, Tenn], Durasul [Zimmer, Warsaw, had], n = 103) liners. The most frequent reasons for revision were loosening (35%), instability (28%), and infection (21%) and were not related to polyethylene formulation (P = .17). Annealed and remelted liners had comparable linear penetration rates (0.03 and 0.04 mm/y, respectively, on average), and these were significantly lower than the rate in conventional retrievals (0.11 mm/y, P <= .0005). This retrieval study including first-generation highly cross-linked liners demonstrated lower wear than conventional polyethylene. Although loosening remained as the most prevalent reason for revision, we could not demonstrate a relationship between wear and loosening. The long-term clinical performance of first-generation highly cross-linked remains promising based on the midterm outcomes of the components documented in this study.