Division of Orthopaedic Surgery, The Ottawa Hospital, General Campus, Ottawa, Ontario, Canada.
Orthopaedic Biomechanics Laboratory, Division of Orthopaedic Surgery, The Ottawa Hospital Research Institute, Civic Campus, Ottawa, Ontario, Canada.
J Arthroplasty. 2019 Jul;34(7):1509-1513. doi: 10.1016/j.arth.2019.03.025. Epub 2019 Mar 14.
The introduction of highly cross-linked polyethylene (HXLPE) acetabular liners has greatly improved the wear performance of metal-on-PE bearing surfaces used in total hip arthroplasty. Changing the sterilization environment and adding thermal treatments, such as remelting or annealing, were introduced to limit on-shelf and in vivo oxidation of cross-linked liners. This study compares the wear properties of the remelted A-CLASS (MicroPort) HXLPE liner to a sequentially annealed HXLPE.
This retrospective study assessed linear and volumetric wear rates using Martell Hip Analysis Suite, and clinical performance through incidences of revision surgeries. A total of 80 remelted and 53 annealed liners were included in the wear analysis. All hips were reviewed for revisions.
There were no significant differences in steady-state linear or volumetric wear rates for remelted and annealed liners, 0.01 (-0.07 to 0.14) vs -0.01 (-0.11 to 0.1) mm/y (P = .28) and -1.03 (-30.99 to 45.43) vs -1.31 (-32.23 to 23.70) mm/y (P = .30), respectively. Both cohorts were below the 0.1 mm/y linear wear threshold. The wear rates for patients with femoral head sizes ≥36 mm were not significantly different than those with 32 and 28 mm femoral head sizes (P = .60). Similarly, wear rates for patients with an excessively vertical acetabular component (>50°) were not significantly different than those with standard acetabular component orientations (P = .97). No hips were revised due to liner-related complications.
The wear rates of the A-CLASS remelted HXLPE acetabular liner wear rates were comparable to those of a sequentially annealed HXLPE. Further long-term studies are required to ensure acceptable resistance to fatigue and in vivo oxidation.
高度交联聚乙烯（HXLPE）髋臼衬垫的引入极大地改善了全髋关节置换中金属对聚乙烯轴承表面的磨损性能。改变灭菌环境并添加热处理（如重熔或退火）是为了限制交联衬垫的货架期和体内氧化。本研究比较了重熔 A-CLASS（微传）HXLPE 衬垫与顺序退火 HXLPE 的磨损性能。
这项回顾性研究使用 Martell Hip Analysis Suite 评估线性和体积磨损率，并通过翻修手术的发生率评估临床性能。共纳入 80 个重熔和 53 个退火衬垫进行磨损分析。所有髋关节均进行了翻修评估。
重熔和退火衬垫的稳态线性和体积磨损率无显著差异，分别为 0.01（-0.07 至 0.14）与-0.01（-0.11 至 0.10）mm/y（P=.28）和-1.03（-30.99 至 45.43）与-1.31（-32.23 至 23.70）mm/y（P=.30）。两个队列的线性磨损率均低于 0.1mm/y 的阈值。股骨头尺寸≥36mm 的患者的磨损率与股骨头尺寸为 32mm 和 28mm 的患者无显著差异（P=.60）。同样，髋臼组件位置异常垂直（>50°）的患者的磨损率与标准髋臼组件位置的患者无显著差异（P=.97）。没有因衬垫相关并发症而进行翻修的髋关节。
A-CLASS 重熔 HXLPE 髋臼衬垫的磨损率与顺序退火 HXLPE 的磨损率相当。需要进一步的长期研究以确保其具有可接受的抗疲劳和体内氧化能力。
