Conventional polyethylene bearings yielded elevated wear rates 15 years after THA
Published results showed use of conventional polyethylene bearings during total hip arthroplasty may lead to sustained, elevated linear and volumetric wear rates 15 years postoperatively in patients aged 50 years or younger.
Jeffrey B. Stambough, MD, and colleagues performed a retrospective review of 101 hips in 84 patients aged 50 years or younger who underwent THA with a conventional polyethylene bearing. At an average follow-up of 17.1 years, researchers collected linear and volumetric wear rates, clinical outcome scores, implant survivorship and patient mortality, and calculated wear rates using Martell Software.
Results showed a median linear wear rate of 0.106 mm per year and a median volumetric wear rate of 43.58 mm3 per year. At 15-year follow-up, researchers found a 36-point and 2-point improvement in the modified Harris hip score and the University of California, Los Angeles activity scores, respectively. Revision occurred in 21.8% of hips, according to results, of which 12.8% were for wear-related causes. Researchers noted patients with inflammatory avascular necrosis preoperatively had a significantly higher mortality rate.
“At 15-year follow-up, conventional polyethylene (CPE) bearings in young patients pursuing total hip arthroplasty demonstrates concerning linear and volumetric wear rates that are an order of magnitude greater than their highly crosslinked counterparts,” Stambough told Healio.com/Orthopedics. “There is a significantly increased incidence of revisions for wear-related problems between 14 [years] and 20 years, which underscores the importance of alternative bearings in this young patient population. Furthermore, these findings underscore the importance for ongoing surveillance and possibly earlier intervention to prevent catastrophic failure in patients with CPE bearings.” – by Casey Tingle
Disclosures: Stambough reports he is an American Association of Hip and Knee Surgeons Education Committee Member. Please see the full study for a list of all other authors’ relevant financial disclosures.