Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota.
J Arthroplasty. 2024 Sep;39(9S2):S347-S352. doi: 10.1016/j.arth.2024.06.042. Epub 2024 Jul 2.
There is a paucity of data beyond 15 years on the survivorship of total hip arthroplasty since the introduction of highly cross-linked polyethylene (HXLPE) liners. Our aim was to evaluate implant survivorship, liner wear rates, and clinical outcomes after primary total hip arthroplasty using HXLPE liners implanted between 1999 and 2002.
Between 1999 and 2002, 690 primary total hip arthroplasties utilizing 28-mm femoral heads and HXLPE liners of a single design were identified using our institutional total joint registry. Femoral heads were made of metal in 96% of cases and ceramic in 4%. The mean age was 56 years, 48% were women, and the mean body mass index was 30. Survivorship analyses were performed for the outcomes of implant revision, reoperation, and complications for the entire cohort. Linear HXLPE liner wear rates were determined on 197 hips with radiographs with more than 18.5 years of follow-up.
At 20 years, survivorship free of revision was 94%, free of reoperation was 92%, and free of any complication was 81%. There were no documented wear-related revisions. The linear wear rate at a mean of 20.3 years postoperatively was 0.02 mm/y. There was no statistically significant difference in measured wear observed between the first available postoperative radiographs and those taken at the final follow-up. The use of elevated liners, patient body mass index, age, preoperative diagnosis, acetabular component inclination, and anteversion angles were not associated with increased wear rates. Mean Harris hip scores improved from 52 preoperatively to 90 at greater than 18.5 years CONCLUSIONS: Primary total hip arthroplasties using a single first-generation HXLPE liner demonstrated excellent survivorship and clinical outcomes at long-term follow-up with no wear-related revisions. Wear rates of HXLPE liners at 20 years are exceedingly low and are not significantly impacted by acetabular component position or patient-dependent variables such as BMI.
IV.
自高交联聚乙烯（HXLPE）衬垫问世以来，超过 15 年的全髋关节置换术存活率数据很少。我们的目的是评估在 1999 年至 2002 年间植入的使用 HXLPE 衬垫的初次全髋关节置换术后的假体存活率、衬垫磨损率和临床结果。
通过我们的机构全关节登记处，在 1999 年至 2002 年间确定了 690 例使用 28 毫米股骨头和单一设计 HXLPE 衬垫的初次全髋关节置换术。96%的股骨头为金属，4%为陶瓷。平均年龄为 56 岁，48%为女性，平均体重指数为 30。对整个队列的假体翻修、再次手术和并发症的结果进行了生存分析。对 197 例随访时间超过 18.5 年的 X 线片进行了 HXLPE 线性衬垫磨损率的测定。
20 年时，无翻修存活率为 94%，无再次手术存活率为 92%，无任何并发症存活率为 81%。没有与磨损相关的翻修记录。平均术后 20.3 年的线性磨损率为 0.02mm/y。在第一次术后 X 线片和最后一次随访时拍摄的 X 线片中，测量到的磨损没有统计学上的显著差异。使用高衬垫、患者体重指数、年龄、术前诊断、髋臼组件倾斜角和前倾角与增加的磨损率无关。平均 Harris 髋关节评分从术前的 52 分提高到 18.5 年以上的 90 分。
在长期随访中，使用单一第一代 HXLPE 衬垫的初次全髋关节置换术具有优异的存活率和临床结果，没有与磨损相关的翻修。HXLPE 衬垫在 20 年时的磨损率极低，并且髋臼组件位置或 BMI 等患者相关变量没有显著影响。
IV。
