Highly cross-linked versus conventional polyethylene inserts in total hip arthroplasty,a five-year Roentgen stereophotogrammetric analysis randomised controlled trial  

作　　者：Justin van Loon Daniël Hoornenborg Inger Sierevelt Kim TM Opdam Gino MMJ Kerkhoffs Daniël Haverkamp 

机构地区：[1]Department of Orthopaedic Surgery,Xpert Orthopedie Amsterdam/Specialized Center of Orthopedic Research and Education,Amsterdam 1101EA,Netherlands [2]Department of Orthopaedic Surgery,Amsterdam University Medical Centres,Location Academic Medical Center,Amsterdam 1105AZ,Netherlands

出　　处：《World Journal of Orthopedics》2020年第10期442-452,共11页世界骨科杂志（英文版）

摘　　要：BACKGROUND Polyethylene(PE)particles produced by wear of the acetabular insert are thought to cause osteolysis and thereby aseptic loosening of the implant in total hip arthroplasty(THA).As highly cross-linked polyethylene(HXLPE)is presumed to give lower wear rates,in vivo studies are needed to confirm this.AIM To compare the wear of REXPOL,a HXPLE,with conventional PE within the first five years after implantation using Roentgen stereophotogrammetric analysis(RSA).METHODS Patients were randomised to receive either a HXLPE(REXPOL)or a conventional PE insert during primary THA.RSA images were obtained directly postoperative and after 6 wk,12 wk,6 mo,12 mo,24 mo and five years.Functional outcomes were assessed using the Hip Injury and Osteoarthritis Outcome Score and Harris Hip Score at baseline and five years after surgery.RESULTS The HXLPE(REXPOL)showed less wear in the latero-medial direction.Significant wear rates of conventional PE were seen in the latero-medial and center-proximal direction and in volume and corrected volume,whereas the REXPOL did not show these outcomes over time.Improvement from baseline in functional outcome did not significantly differ.CONCLUSION Total 3D wear is less in THAs inserted with a REXPOL inlay than a conventional PE inlay after five years.This study confirms,for the first,that the REXPOL HXLPE inlay is preferred to standard PE.

关 键 词：Highly cross-linked polyethylene Primary total hip arthroplasty Polyethylene wear Roentgen stereophotogrammetric analysis 

分 类 号：R687.4[医药卫生—骨科学]