Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
Department of Orthopaedics and Traumatology, Experimental Orthopaedics, Medical University of Innsbruck, Sonnenburgstrasse 16, 6020, Innsbruck, Austria.
Arch Orthop Trauma Surg. 2021 Sep;141(9):1591-1599. doi: 10.1007/s00402-021-03832-0. Epub 2021 Mar 4.
The purpose of this study was (1) to compare early wear rates in bedding-in periods of two highly cross-linked polyethylene liners frequently used in THA and (2) to evaluate risk factors indicating a possible higher wear rate.
1120 patients who received a Crossfire or a Marathon highly cross-linked (HXLPE) ultra-high-molecular-weight polyethylene liner in primary THA at our Department between 2004 and 2018 were retrospectively reviewed. Patients with (1) only alumina heads on HXLPE acetabular bearings, (2) a minimum of four radiographs per patient for EBRA analysis, (3) no osteolysis around the acetabular cup and (4) no dislocations that occurred during the study period were included.
A total of 328 patients (female: 183; male: 145; Marathon: 179; Crossfire: 149) fulfilled the inclusion criteria. Mean follow-up was 24 (range 7-51) months. With 0.22 (SD 0.27) mm mean total wear for the Marathon was three times greater than for the Crossfire, namely 0.07 (SD 0.14) mm. Mean cup migration during the investigated follow-up period was 0.7 (SD 0.8) mm for the Pinnacle and 0.5 mm (SD 0.7) for the Trident PSL cups.
Initial early wear of highly cross-linked polyethylene in combination with alumina heads differs strongly between products. Long-term survivorship of these liners should be observed to determine whether early wear has an impact on aseptic loosening.
Level III (retrospective comparative study with prospective cohort).
本研究的目的是：(1) 比较两种常用于全髋关节置换术（THA）的高交联聚乙烯衬垫在磨合期间的早期磨损率；(2) 评估表明可能存在更高磨损率的风险因素。
回顾性分析了 2004 年至 2018 年期间我科收治的 1120 例接受 Crossfire 或 Marathon 高交联（HXLPE）超高分子量聚乙烯衬垫初次 THA 的患者。纳入标准为：(1) HXLPE 髋臼轴承仅为氧化铝头；(2) 每位患者至少有 4 张射线照片进行 EBRA 分析；(3) 髋臼杯周围无溶骨；(4) 研究期间无脱位。
共 328 例患者（女性 183 例，男性 145 例；Marathon 179 例，Crossfire 149 例）符合纳入标准。平均随访时间为 24 个月（7-51 个月）。Marathon 的平均总磨损率为 0.22（SD 0.27）mm，是 Crossfire 的三倍，即 0.07（SD 0.14）mm。在研究期间，Pinnacle 的髋臼杯平均迁移量为 0.7（SD 0.8）mm，Trident PSL 髋臼杯为 0.5mm（SD 0.7）mm。
高交联聚乙烯与氧化铝头的初始早期磨损在不同产品之间存在显著差异。这些衬垫的长期存活率应得到观察，以确定早期磨损是否会影响无菌性松动。
III 级（前瞻性队列研究）。
