TY - JOUR
T1 - Highly cross-linked versus conventional polyethylene inserts in total hip arthroplasty, a five-year Roentgen stereophotogrammetric analysis randomised controlled trial
AU - van Loon, Justin
AU - Hoornenborg, Daniël
AU - Sierevelt, Inger
AU - Opdam, Kim T. M.
AU - Kerkhoffs, Gino M. MJ
AU - Haverkamp, Daniël
PY - 2020/10/18
Y1 - 2020/10/18
N2 - 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.
AB - 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.
KW - Highly cross-linked polyethylene
KW - Polyethylene wear
KW - Primary total hip arthroplasty
KW - Roentgen stereophotogrammetric analysis
UR - http://www.scopus.com/inward/record.url?scp=85096952830&partnerID=8YFLogxK
U2 - https://doi.org/10.5312/wjo.v11.i10.442
DO - https://doi.org/10.5312/wjo.v11.i10.442
M3 - Article
C2 - 33134107
SN - 2218-5836
VL - 11
SP - 442
EP - 452
JO - World journal of orthopedics
JF - World journal of orthopedics
IS - 10
M1 - 10.5312/wjo.v11.i10.442
ER -