Goyal Prateek, Howard James L, Yuan Xunhua, Teeter Matthew G, Lanting Brent A
Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Imaging Research Laboratories, Robarts Research Institute, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
J Arthroplasty. 2017 May;32(5):1670-1674. doi: 10.1016/j.arth.2016.11.057. Epub 2016 Dec 14.
Studies that have previously examined the relationship between acetabular component inclination angle and polyethylene wear have shown increased wear of conventional polyethylene with high inclination angles. To date, there are no long-term in vivo studies examining the correlation between cup position and polyethylene wear with highly crosslinked polyethylene.
An institutional arthroplasty database was used to identify patients who had metal-on-highly crosslinked polyethylene primary total hip arthroplasty using the same component design with a minimum follow-up of 10 years. A modified radiostereometric analysis examination setup was utilized, recreating standard anteroposterior and cross-table lateral examinations in a single stereo radiostereometric analysis acquisition. The same radiographs were used to measure inclination angle and anteversion.
A total of 43 hips were included for analysis in this study. Average follow-up was 12.3 ± 1.2 years. The average linear wear rate was calculated to be 0.066 ± 0.066 mm/y. Inclination angle was not correlated with polyethylene wear rate (P = .82). Anteversion was also not correlated with polyethylene wear rate (P = .11).
At long-term follow-up of >10 years, highly crosslinked polyethylene has a very low wear rate. This excellent tribology is independent of acetabular position. The low wear rate highlights the excellent results of metal on highly crosslinked polyethylene, and supports its use in total hip arthroplasty.
先前研究髋臼假体倾斜角度与聚乙烯磨损之间关系的研究表明，传统聚乙烯在高倾斜角度下磨损增加。迄今为止，尚无长期体内研究探讨髋臼位置与高交联聚乙烯磨损之间的相关性。
利用机构关节置换数据库，确定接受金属对高交联聚乙烯初次全髋关节置换术且采用相同假体设计、随访至少10年的患者。采用改良的放射立体分析检查设置，在单次立体放射立体分析采集过程中重现标准前后位和交叉台侧位检查。使用相同的X线片测量倾斜角度和前倾角。
本研究共纳入43例髋关节进行分析。平均随访时间为12.3±1.2年。计算得出平均线性磨损率为0.066±0.066mm/年。倾斜角度与聚乙烯磨损率无关（P = 0.82）。前倾角也与聚乙烯磨损率无关（P = 0.11）。
在超过10年的长期随访中，高交联聚乙烯磨损率极低。这种优异的摩擦学特性与髋臼位置无关。低磨损率突出了金属对高交联聚乙烯的优异效果，并支持其在全髋关节置换术中的应用。
