Yan Yufei, Chen Hao, Feng Jianmin, Chen Kaizhe, Zhou Kaidi, Hong Weixiang, Wang Yi, Liu Zhihong, Zhang Jiong, Yang Qingming, Guo Lei, He Chuan
Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai, China.
Department of Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, People's Republic of China.
Int Orthop. 2017 Apr;41(4):723-730. doi: 10.1007/s00264-016-3217-0. Epub 2016 May 13.
The aim of the present study was to investigate the long-term outcome and the wear characteristics of two distinct types of ultra-high molecular weight polyethylene (UHMWPE) liners in total hip arthroplasty (THA).
We conducted a retrospective clinical study on patients which were treated with total hip arthroplasty using either Enduron polyethylene (Enduron PE) or Trilogy polyethylene (Trilogy PE) liners based on a minimum of ten year follow up data. Morphological analyses of wear particles from tissue samples, which were harvested during revision surgeries, were also performed.
A total of 79 THAs in the Enduron group and 55 THAs in the Trilogy group were available for analysis. Kaplan-Meier survival with revision for wear-related complications as the endpoint of the Enduron PE liners was lower than that of Trilogy PE liners at ten years (93.5 % and 100 %, P = 0.03). The Enduron group had higher mean linear wear rate than that of the Trilogy group (0.20 ± 0.09 and 0.09 ± 0.03 mm/year, P < 0.01). The incidence of osteolysis for the Enduron group was higher than that of the Trilogy group (33.3 % and 12 %, P = 0.04). Under transmission electron microscopy, the Enduron group had more than 82 % of the particles less than 1.0 μm in size and more than 57 % of the particles less than 0.5 μm.
The long-term performance of Enduron liners was worse than that of Trilogy liners. Further clinical follow-up may be necessary in patients with Enduron PE liners in order to avoid catastrophic complications.
本研究旨在调查全髋关节置换术（THA）中两种不同类型的超高分子量聚乙烯（UHMWPE）衬垫的长期疗效和磨损特性。
我们基于至少十年的随访数据，对使用Enduron聚乙烯（Enduron PE）或Trilogy聚乙烯（Trilogy PE）衬垫进行全髋关节置换术治疗的患者进行了一项回顾性临床研究。还对翻修手术期间采集的组织样本中的磨损颗粒进行了形态学分析。
Enduron组共有79例THA，Trilogy组有55例THA可供分析。以与磨损相关的并发症翻修为终点的Enduron PE衬垫的十年Kaplan-Meier生存率低于Trilogy PE衬垫（93.5%和100%，P = 0.03）。Enduron组的平均线性磨损率高于Trilogy组（0.20±0.09和0.09±0.03 mm/年，P < 0.01）。Enduron组的骨溶解发生率高于Trilogy组（33.3%和12%，P = 0.04）。在透射电子显微镜下，Enduron组超过82%的颗粒尺寸小于1.0μm，超过57%的颗粒尺寸小于0.5μm。
Enduron衬垫的长期性能比Trilogy衬垫差。对于使用Enduron PE衬垫的患者，可能需要进一步的临床随访以避免灾难性并发症。
