Remily Ethan A, Douglas Scott J, Sax Oliver C, Pervaiz Sahir S, Mohamed Nequesha S, Wilkie Wayne A, Smith Langan S, Nace James, Malkani Arthur L, Jaggard Charles E, Kolisek Frank R, Delanois Ronald E
Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA.
Department of Orthopaedic Surgery, University of Louisville Adult Reconstruction Program, Louisville, KY, USA.
Arthroplast Today. 2021 Sep 9;11:140-145. doi: 10.1016/j.artd.2021.08.002. eCollection 2021 Oct.
There is a paucity of data on the long-term performance of highly cross-linked polyethylene (HXLPE). Therefore, this study evaluated 10-year 1) functional, 2) radiographic, and 3) surgical outcomes in patients who underwent total hip arthroplasty with sequentially irradiated and annealed HXLPE.
A retrospective, multicenter study was conducted on patients who underwent primary total hip arthroplasty and received HXLPE polymer (n = 151). Two-dimensional radiographic linear and volumetric wear analyses were quantified using the Martell Hip Analysis software, while functional outcomes were assessed by analyzing postoperative Short-Form-12 (SF-12) Physical and Mental Health Surveys and Harris Hip Scores. Radiographic outcomes included yearly linear (mm/y) and volumetric (mm/y) wear rates. Surgical outcomes included additional operations and survivorship.
SF-12 scores were within 1 standard deviation (SD) of the normal population (SF-12 Physical: 47.0; SF-12 Mental: 52.0), while the Harris Hip Scores of 89.5 was borderline between "good" and "excellent." Total and annual linear wear rates were 0.164 mm (SD: 0.199 mm) and 0.015 mm/y (SD: 0.018 mm/y), respectively. The mean total volumetric wear rate was 141.4 mm (SD: 165.0) and 12.6 mm/y (SD: 14.9 mm/y) when broken down into a yearly rate. Eleven patients required revisions, resulting in an all-cause polyethylene survivorship of 92.7%, with a polyethylene wear survivorship of 100.0%.
Our results demonstrate clinically undetectable linear and volumetric wear rates after 10 years in those who received the unique sequentially irradiated and annealed HXLPE. Furthermore, high rates of survivorship coupled with low all-cause revision rates illustrate the polymers' capability to potentially increase implant longevity.
关于高度交联聚乙烯（HXLPE）长期性能的数据较少。因此，本研究评估了接受序贯辐照和退火HXLPE全髋关节置换术患者的10年：1）功能、2）影像学和3）手术结局。
对接受初次全髋关节置换术并使用HXLPE聚合物的患者（n = 151）进行了一项回顾性多中心研究。使用Martell髋关节分析软件对二维影像学线性和体积磨损分析进行量化，同时通过分析术后简短健康调查简表（SF-12）身体和心理健康调查以及Harris髋关节评分来评估功能结局。影像学结局包括每年的线性（mm/年）和体积（mm/年）磨损率。手术结局包括再次手术和生存率。
SF-12评分在正常人群的1个标准差（SD）范围内（SF-12身体：47.0；SF-12心理：52.0），而Harris髋关节评分为89.5，处于“良好”和“优秀”之间的临界值。总线性磨损率和年线性磨损率分别为0.164 mm（SD：0.199 mm）和0.015 mm/年（SD：0.018 mm/年）。按年率分解时，平均总体积磨损率为141.4 mm（SD：165.0）和12.6 mm/年（SD：14.9 mm/年）。11例患者需要翻修，全因聚乙烯生存率为92.7%，聚乙烯磨损生存率为100.0%。
我们的结果表明，接受独特的序贯辐照和退火HXLPE的患者在10年后的线性和体积磨损率在临床上无法检测到。此外，高生存率和低全因翻修率说明了该聚合物有可能提高植入物使用寿命的能力。
