Dataset Information

The Survivorship of the Uncemented Iso-Elastic Monoblock Acetabular Component at a Mean of 6-Year Follow-up.

ABSTRACT:

Background

Aseptic loosening, caused by wear and osteolysis, is the most frequent reason for hip replacement revision in the UK. To prevent aseptic loosening, an acetabular component with vitamin E added to irradiated highly cross-linked polyethylene (HXLPE) was developed to reduce oxidative degradation.

Questions/purposes

A prior study of the vitamin E-blended HXLPE acetabular component after 2 years of follow-up reported no adverse reactions or abnormal mechanical behavior. To further examine this hypothesis of reducing wear and osteolysis, we sought to evaluate outcomes after 6-year follow-up.

Methods

A cohort of 95 of the 112 initial patients (84.2%) completed the 6 years of follow-up after receiving a vitamin E-blended HXLPE acetabular component. Evaluation was performed in terms of clinical (visual analog scale [VAS] score, VAS score with weight-bearing, VAS score for satisfaction, and Harris Hip Score) and radiological (inclination, polar gap, radiolucencies, migration, and 2-D linear femoral head penetration rate) assessment.

Results

The mean VAS score for patient satisfaction was 8.75 and the mean Harris Hip Score was 91.8. There were two revisions because of deep infections and one because of a peri-prosthetic femoral fracture. Two acetabular components migrated initially; however, delayed acetabular stabilization occurred. Both patients had good clinical scores at 72 months. The mean femoral head penetration rate was 0.036 mm/year.

Conclusions

This prospective cohort study has shown no adverse reactions concerning the vitamin E additive, promising wear rates, no signs of osteolysis, a 100% survival rate for aseptic loosening, and an all-cause survivorship percentage of 97.4% at 6 years of follow-up.

SUBMITTER: Snijders TE

PROVIDER: S-EPMC6973989 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The Survivorship of the Uncemented Iso-Elastic Monoblock Acetabular Component at a Mean of 6-Year Follow-up.

Snijders T E TE Halma J J JJ Massier J R A JRA van Gaalen S M SM de Gast A A

HSS journal : the musculoskeletal journal of Hospital for Special Surgery 20190410 1

<h4>Background</h4>Aseptic loosening, caused by wear and osteolysis, is the most frequent reason for hip replacement revision in the UK. To prevent aseptic loosening, an acetabular component with vitamin E added to irradiated highly cross-linked polyethylene (HXLPE) was developed to reduce oxidative degradation.<h4>Questions/purposes</h4>A prior study of the vitamin E-blended HXLPE acetabular component after 2 years of follow-up reported no adverse reactions or abnormal mechanical behavior. To f ...[more]

PMID: 32015736

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Project description:Background and purpose - Backside wear of the polyethylene insert in total knee arthroplasty (TKA) can produce clinically significant levels of polyethylene debris, which can lead to loosening of the tibial component. Loosening due to polyethylene debris could theoretically be reduced in tibial components of monoblock polyethylene design, as there is no backside wear. We investigated the effect of 2 different tibial component designs, monoblock and modular polyethylene, on migration of the tibial component in uncemented TKA. Patients and methods - In this randomized study, 53 patients (mean age 61 years), 32 in the monoblock group and 33 in the modular group, were followed for 2 years. Radiostereometric analysis (RSA) was done postoperatively after weight bearing and after 3, 6, 12, and 24 months. The primary endpoint of the study was comparison of the tibial component migration (expressed as maximum total point motion (MTPM)) of the 2 different implant designs. Results - We did not find any statistically significant difference in MTPM between the groups at 3 months (p = 0.2) or at 6 months (p = 0.1), but at 12 and 24 months of follow-up there was a significant difference in MTPM of 0.36 mm (p = 0.02) and 0.42 mm (p = 0.02) between groups, with the highest amount of migration (1.0 mm) in the modular group. The difference in continuous migration (MTPM from 12 and 24 months) between the groups was 0.096 mm (p = 0.5), and when comparing MTPM from 3-24 months, the difference between the groups was 0.23 mm (p = 0.07). Interpretation - In both study groups, we found the early migration pattern expected, with a relatively high initial amount of migration from operation to 3 months of follow-up, followed by stabilization of the implant with little migration thereafter. However, the modular implants had a statistically significantly higher degree of migration compared to the monoblock. We believe that the greater stiffness of the modular implants was the main reason for the difference in migration, but an initial creep in the polyethylene metal-back locking mechanism of the modular group could also be a possible explanation for the observed difference in migration between the 2 study groups.

Dataset Information

The Survivorship of the Uncemented Iso-Elastic Monoblock Acetabular Component at a Mean of 6-Year Follow-up.

Background

Questions/purposes

Methods

Results

Conclusions

Publications

The Survivorship of the Uncemented Iso-Elastic Monoblock Acetabular Component at a Mean of 6-Year Follow-up.

Similar Datasets

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