The Center for Hip and Knee Surgery, St Francis Hospital, Mooresville, 1199 Hadley Road, Mooresville, IN 46158, USA.
Clin Orthop Relat Res. 2011 Feb;469(2):405-11. doi: 10.1007/s11999-010-1571-6.
Polyethylene wear may be affected by the type of polyethylene resin, manufacturing technique, degree of thermal stabilization, and sterilization technique.
QUESTIONS/PURPOSES: We therefore compared femoral head penetration into the PE and cup survival using the same cup system with different PE resins, manufacturing, and sterilization techniques.
Our study group consisted of 1912 THAs performed using the same uncemented cup and identical 28-mm cobalt-chrome heads. The polyethylene varied as follows: Group 1 (94 cups), GUR 4150 resin, ram-extruded, sterilized in air, no barrier packaging; Group 2 (74 cups), same as Group 1 but sterilized in argon; Group 3 (75 cups), Himont 1900 resin, compression-molded bar stock, sterilized in argon, no barrier packaging; Group 4 (620 cups), same as Group 3 except with barrier packing; Group 5 (711 cups), GUR 1050 resin, compression-molded bar stock, sterilized in argon gas with barrier packaging; and Group 6 (338 cups), GUR 1050 resin, compression-molded bar stock, sterilized in argon with barrier packaging, irradiated with 50 kGy, heated below melting temperature, machined, and finally placed in nonbarrier packaging with gas plasma sterilization. Minimum followup was 2 years (average, 7 years; range, 2-17 years).
Femoral head penetration averaged 0.05 mm per year for Groups 5 and 6 and was substantially lower than for Groups 1 to 4. Cup survival was higher at seven years in Groups 3, 4, and 5, and at 10 years in group 4 when compared to groups 1, 2, and 3.
We observed lower FHP rates and higher cup survival with polyethylene machined from direct compression-molded bar stock, sterilized in argon gas, with barrier packaging.
Level III Therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
聚乙烯磨损可能受到聚乙烯树脂类型、制造技术、热稳定程度和灭菌技术的影响。
问题/目的：因此，我们比较了使用相同杯系统但具有不同聚乙烯树脂、制造和灭菌技术的股骨头穿透聚乙烯和杯体存活率。
我们的研究组包括 1912 例采用相同非骨水泥杯和相同 28 毫米钴铬股骨头的全髋关节置换术。聚乙烯的变化如下：第 1 组（94 个杯），GUR4150 树脂，挤压成型，空气灭菌，无屏障包装；第 2 组（74 个杯），与第 1 组相同，但在氩气中灭菌；第 3 组（75 个杯），Himont1900 树脂，压缩成型棒料，在氩气中灭菌，无屏障包装；第 4 组（620 个杯），与第 3 组相同，只是采用了屏障包装；第 5 组（711 个杯），GUR1050 树脂，压缩成型棒料，在氩气中灭菌并采用屏障包装；第 6 组（338 个杯），GUR1050 树脂，压缩成型棒料，在氩气中灭菌并用屏障包装，辐照 50kGy，加热至低于熔点，机械加工，最后采用非屏障包装并气体等离子体灭菌。最低随访时间为 2 年（平均 7 年；范围 2-17 年）。
第 5 组和第 6 组股骨头穿透的平均每年为 0.05 毫米，明显低于第 1 至 4 组。第 3、4 和 5 组在 7 年时杯体存活率较高，第 4 组在 10 年时杯体存活率较高，而第 1、2 和 3 组则较低。
我们观察到使用直接压缩成型棒料、在氩气中灭菌、采用屏障包装的聚乙烯加工的股骨头穿透率较低，杯体存活率较高。
III 级治疗研究。请参见作者指南以获取完整的证据水平描述。
