Sikora Hanna, Gabor Jadwiga, Roczniok Robert, Kusz Damian, Swinarew Andrzej
Scanmed Sport Clinic, ul. Bankowa 2, 44-244 Żory, Poland.
Faculty of Science and Technology, University of Silesia in Katowice, ul. 75 Pułku Piechoty 1A, 41-500 Chorzów, Poland.
J Clin Med. 2024 May 7;13(10):2751. doi: 10.3390/jcm13102751.
Aseptic loosening is the leading cause of late revision in total hip arthroplasty, primarily due to degenerative oxidation of polyethylene components, leading to wear particle formation and periacetabular osteolysis. This study aimed to analyze the oxidation levels in polyethylene liners and cemented cups retrieved from revision surgeries using Fourier-transform infrared spectroscopy (FTIR) and to explore the correlation between oxidation levels and factors such as head size, head material, fixation method, and implant survival time. Polyethylene liners and cups were analyzed post-revision surgery to assess oxidation levels, which were then compared to periacetabular bone loss measured by the Paprosky classification. This study evaluated the impact of head size (28 mm vs. 32 mm), head material (ceramic vs. metal), and fixation methods on oxidation. The relationship between the mean oxidation index (OI) and implant survival time was also investigated. There was a significant positive correlation between the mean oxidation index of the polyethylene components and the severity of periacetabular osteolysis according to the Paprosky scale. While the mean OI for samples articulating with ceramic heads was lower than for those with metal heads, and the mean OI for samples with a 32 mm head size was lower than for those with a 28 mm size, these differences were not statistically significant. Furthermore, the fixation method did not affect the oxidation index, and no correlation was found between OI and the survival time of the implants. This study confirms a direct correlation between polyethylene oxidation and periacetabular osteolysis in hip replacements, highlighting the importance of material choice and design in potentially reducing the risk of aseptic loosening. Despite the lack of significant differences in oxidation levels based on head material and size, these factors may still play a role in the long-term outcome of hip arthroplasty, warranting further investigation.
无菌性松动是全髋关节置换术后翻修的主要原因，主要是由于聚乙烯部件的退化性氧化，导致磨损颗粒形成和髋臼周围骨溶解。本研究旨在使用傅里叶变换红外光谱（FTIR）分析翻修手术中取出的聚乙烯内衬和骨水泥杯的氧化水平，并探讨氧化水平与头部尺寸、头部材料、固定方法和植入物存活时间等因素之间的相关性。翻修手术后对聚乙烯内衬和杯进行分析以评估氧化水平，然后将其与通过Paprosky分类法测量的髋臼周围骨丢失情况进行比较。本研究评估了头部尺寸（28mm与32mm）、头部材料（陶瓷与金属）和固定方法对氧化的影响。还研究了平均氧化指数（OI）与植入物存活时间之间的关系。根据Paprosky分级，聚乙烯部件的平均氧化指数与髋臼周围骨溶解的严重程度之间存在显著正相关。虽然与陶瓷头关节连接的样本的平均OI低于与金属头关节连接的样本，并且头部尺寸为32mm的样本的平均OI低于头部尺寸为28mm的样本，但这些差异无统计学意义。此外，固定方法不影响氧化指数，且未发现OI与植入物存活时间之间存在相关性。本研究证实了髋关节置换术中聚乙烯氧化与髋臼周围骨溶解之间存在直接关联，突出了材料选择和设计在潜在降低无菌性松动风险方面的重要性。尽管基于头部材料和尺寸的氧化水平缺乏显著差异，但这些因素仍可能在髋关节置换术的长期结果中发挥作用，值得进一步研究。
