State University of New York Medical Center, NY, USA.
Acta Orthop. 2012 Aug;83(4):366-73. doi: 10.3109/17453674.2012.717843. Epub 2012 Aug 10.
There have been few reports documenting the wear and oxidation performance of the polyethylene bearing surface of HGPI and HGPII THA devices. We evaluated retrieved HGPI and HGPII acetabular liners that had been in situ for more than 10 years and determined whether there was a relationship between clinical and radiographic factors, surface damage, wear, and oxidation.
129 HGPI and II acetabular liners with implantation times of > 10 years were retrieved at 4 institutions between 1997 and 2010. The liners were made from a single resin and were gamma radiation-sterilized in air. Surface damage, linear wear, and oxidation index (OI) were assessed. Differences in clinical and radiographic factors, surface damage, linear wear, and OI for the 2 designs were statistically evaluated separately and together.
Articular surface damage and backside damage was similar in the 2 designs. The linear penetration rate was 0.14 (SD 0.07) mm/year for the HGPI liners and 0.12 (SD 0.08) mm/year for the HGPII liners. For both cohorts, the rim had a higher OI than the articular surface. 74% of the liners had subsurface cracking and 24% had a complete fracture through the acetabular rim.
Despite modification of the HGP locking mechanism in the HGPII design, dissociation of the liner from the acetabular shell can still occur if fracture of the rim of the liner develops due to oxidative degradation.
HGPI 和 HGPII THR 装置的聚乙烯轴承表面的磨损和氧化性能鲜有报道。我们评估了在体内超过 10 年的 HGPI 和 HGPII 髋臼衬垫,并确定了临床和影像学因素、表面损伤、磨损和氧化之间是否存在关系。
1997 年至 2010 年间,4 家机构共取出 129 个 HGPI 和 II 髋臼衬垫,其植入时间>10 年。衬垫由单一树脂制成,并在空气中进行γ射线灭菌。评估了表面损伤、线性磨损和氧化指数(OI)。分别对两种设计的临床和影像学因素、表面损伤、线性磨损和 OI 进行了统计学评估,并对两者进行了综合评估。
两种设计的关节面损伤和背面损伤相似。HGPI 衬垫的线性穿透率为 0.14(SD 0.07)mm/年,HGPII 衬垫的线性穿透率为 0.12(SD 0.08)mm/年。对于两个队列,边缘的 OI 均高于关节面。74%的衬垫存在次表面裂纹,24%的衬垫发生完全穿透髋臼边缘的断裂。
尽管在 HGPII 设计中修改了 HGP 锁定机制,但如果由于氧化降解导致衬垫边缘发生断裂,衬垫仍可能从髋臼壳上分离。