We analysed data from 155 revisions of identical cementless hip prostheses to determine the influence of patient-, implant- and surgery-related factors on the polyethylene wear rate and size of periprosthetic osteolysis (OL). This was calculated by logistic regression analysis. Factors associated with an increased/decreased wear rate included position of the cup relative to Kohler's line, increase in abduction angle of the cup, traumatic and inflammatory arthritis as a primary diagnosis, and patient height. Severe acetabular bone defects were predicted by an increased wear rate (odds ratio, OR = 5.782 for wear rate above 200 mm(3)/y), and increased height of the patient (OR = 0.905 per each centimetre). Predictors of severe bone defects in the femur were the increased wear rate (OR = 3.479 for wear rate above 200 mm(3)/y) and placement of the cup outside of the true acetabulum (OR = 3.292). Variables related to surgical technique were the most predictive of polyethylene wear rate.

Nous avons analysé les données de 155 révisions d’une prothèse totale de hanche sans ciment de façon à déterminer les facteurs relatifs aux patients et à l’implant concernant l’utilisation du polyéthylène et l’importance de l’ostéolyse (OL). Les 155 modèles de prothèses étaient identiques. Il s’agit d’une analyse informatique. L’augmentation ou la diminution du taux d’usure était associée à la position de la cupule par rapport à la ligne de Kohler, une cupule verticalisée entraînant plus d’usure. De même en ce qui concerne les arthroses d’origine traumatique ou inflammatoire et le poids des patients. On pouvait prévoir d’importantes lésions d’ostéolyse acétabulaire du fait d’une importante augmentation de l’usure du polyéthylène (OR = 5,782 taux d’usure 707, 200 mm3/an) et l’augmentation du poids des patients (OR = 0,905) pour chaque cm. L’augmentation du taux prédictif d’usure avec des lésions osseuses sévères au niveau du fémur l’étaient également (OR = 3,479 d’usure et 200 mm3/an) de même que le positionnement de la cupule en dehors de l’arrière fond acétabulaire (OR = 3,292). Les facteurs d’usure les plus importants sont surtout d’origine technique et secondaires aux problèmes de technique chirurgicale.

Orthopaedics Palacký University Olomouc Czech Republic

Zobrazit více v PubMed

Pearle AD, Crow MK, Rakshit DS, Wohlgemuth J, Nestor BJ. Distinct inflammatory gene pathways induced by particles. Clin Orthop Relat Res. 2007;458:194–201. PubMed

Drees P, Eckardt A, Gay RE, Gay S, Huber LC. Mechanisms of disease: molecular insights into aseptic loosening of orthopedic implants. Nat Clin Pract Rheumatol. 2007;3:165–171. doi: 10.1038/ncprheum0428. PubMed DOI

McKellop HA. The lexicon of polyethylene wear in artificial joints. Biomaterials. 2007;28:5049–5057. doi: 10.1016/j.biomaterials.2007.07.040. PubMed DOI

Hopper RH, Jr, Engh CA, Jr, Fowlkes LB, Engh CA. The pros and cons of polyethylene sterilization with gamma irradiation. Clin Orthop Relat Res. 2004;429:54–62. doi: 10.1097/01.blo.0000150112.34736.82. PubMed DOI

Schmalzried TP, Dorey FJ, McKellop H. The multifactorial nature of polyethylene wear in vivo. J Bone Joint Surg Am. 1998;80:1234–1242. PubMed

Schmalzried TP, Shepherd EF, Dorey FJ, Jackson WO, Rosa M, et al. The John Charnley Award. Wear is a function of use, not time. Clin Orthop Relat Res. 2000;381:36–46. doi: 10.1097/00003086-200012000-00005. PubMed DOI

Wroblewski BM, Siney PD, Fleming PA. Wear of the cup in the Charnley LFA in the young patient. J Bone Joint Surg Br. 2004;86:498–503. PubMed

Wan Z, Boutary M, Dorr LD. The influence of acetabular component position on wear in total hip arthroplasty. J Arthroplasty. 2008;23:51–56. doi: 10.1016/j.arth.2007.06.008. PubMed DOI

Gallo J, Havranek V, Cechova I, Zapletalova J. Influence of demographic, surgical and implant variables on wear rate and osteolysis in ABG I hip arthroplasty. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2006;150:135–141. PubMed

Gallo J, Langova K, Havranek V, Cechova I. Poor survival of ABG I hip prosthesis in younger patients. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2008;152:163–168. PubMed

Oosterbos CJ, Rahmy AI, Tonino AJ, Witpeerd W. High survival rate of hydroxyapatite-coated hip prostheses: 100 consecutive hips followed for 10 years. Acta Orthop Scand. 2004;75:127–133. doi: 10.1080/00016470412331294365. PubMed DOI

Garcia Araujo C, Fernandez Gonzalez J, Tonino A. Rheumatoid arthritis and hydroxyapatite-coated hip prostheses: five-year results. International ABG Study Group. J Arthroplasty. 1998;13:660–667. doi: 10.1016/S0883-5403(98)80010-7. PubMed DOI

Rossi P, Sibelli P, Fumero S, Crua E. Short-term results of hydroxyapatite-coated primary total hip arthroplasty. Clin Orthop Relat Res. 1995;310:98–102. PubMed

Gallo J, Havranek V, Hrabovsky M. Measurement of retrieved polyethylene cup by universal microscope. Fine Mech Opt. 2003;48:333–338.

Gallo J, Havranek V, Zapletalova J, Mandat D. Measurement of acetabular polyethylene wear of total hip replacement, using a universal measuring microscope. Characteristics of measurements. Acta Chir Orthop Traumatol Cech. 2006;73:28–33. PubMed

Charnley J. The long-term results of low-friction arthroplasty of the hip performed as a primary intervention. J Bone Joint Surg Br. 1972;54:61–76. PubMed

Pagnano W, Hanssen AD, Lewallen DG, Shaughnessy WJ. The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg Am. 1996;78:1004–1014. PubMed

Saleh KJ, Holtzman J, Gafni A, Saleh L, Davis A, et al. Reliability and intraoperative validity of preoperative assessment of standardized plain radiographs in predicting bone loss at revision hip surgery. J Bone Joint Surg Am. 2001;83:1040–1046. PubMed

Wang D, Zhang W, Bakhai A. Comparison of Bayesian model averaging and stepwise methods for model selection in logistic regression. Stat Med. 2004;23:3451–3467. doi: 10.1002/sim.1930. PubMed DOI

Karachalios T, Hartofilakidis G, Zacharakis N, Tsekoura M. A 12- to 18-year radiographic follow-up study of Charnley low-friction arthroplasty. The role of the center of rotation. Clin Orthop Relat Res. 1993;296:140–147. PubMed

Wilkinson JM, Hamer AJ, Stockley I, Eastell R. Polyethylene wear rate and osteolysis: critical threshold versus continuous dose-response relationship. J Orthop Res. 2005;23:520–525. doi: 10.1016/j.orthres.2004.11.005. PubMed DOI

Orishimo KF, Sychterz CJ, Hopper RH, Jr, Engh CA. Can component and patient factors account for the variance in wear rates among bilateral total hip arthroplasty patients? J Arthroplasty. 2003;18:154–160. doi: 10.1054/arth.2003.50023. PubMed DOI

Johnston RC, Brand RA, Crowninshield RD. Reconstruction of the hip. A mathematical approach to determine optimum geometric relationships. J Bone Joint Surg Am. 1979;61:639–652. PubMed

Hirakawa K, Mitsugi N, Koshino T, Saito T, Hirasawa Y, et al. Effect of acetabular cup position and orientation in cemented total hip arthroplasty. Clin Orthop Relat Res. 2001;388:135–142. doi: 10.1097/00003086-200107000-00020. PubMed DOI

Patil S, Bergula A, Chen PC, Colwell CW, Jr, D’Lima DD. Polyethylene wear and acetabular component orientation. J Bone Joint Surg Am. 2003;85(Suppl 4):56–63. PubMed

Del Schutte H, Jr, Lipman AJ, Bannar SM, Livermore JT, Ilstrup D, et al. Effects of acetabular abduction on cup wear rates in total hip arthroplasty. J Arthroplasty. 1998;13:621–626. doi: 10.1016/S0883-5403(98)80003-X. PubMed DOI

Nevelos JE, Ingham E, Doyle C, Nevelos AB, Fisher J. The influence of acetabular cup angle on the wear of "BIOLOX Forte" alumina ceramic bearing couples in a hip joint simulator. J Mater Sci Mater Med. 2001;12:141–144. doi: 10.1023/A:1008970027306. PubMed DOI

Kligman M, Michael H, Roffman M. The effect of abduction differences between cup and contralateral acetabular angle on polyethylene component wear. Orthopedics. 2002;25:65–67. PubMed

Digas G, Karrholm J, Thanner J, Malchau H, Herberts P. Highly cross-linked polyethylene in cemented THA: randomized study of 61 hips. Clin Orthop Relat Res. 2003;417:126–138. PubMed

Chuter GS, Cloke DJ, Mahomed A, Partington PF, Green SM. Wear analysis of failed acetabular polyethylene: a comparison of analytical methods. J Bone Joint Surg Br. 2007;89:273–279. doi: 10.1302/0301-620X.89B2.18158. PubMed DOI

Pierrynowski MR, Galea V. Enhancing the ability of gait analyses to differentiate between groups: scaling gait data to body size. Gait Posture. 2001;13:193–201. doi: 10.1016/S0966-6362(01)00097-2. PubMed DOI

Vassiliou K, Unsworth A. Is the wear factor in total joint replacements dependent on the nominal contact stress in ultra-high molecular weight polyethylene contacts? Proc Inst Mech Eng Part H-J Eng Med. 2004;218:101–107. doi: 10.1243/095441104322983997. PubMed DOI

Jin ZM, Stone M, Ingham E, Fisher J. Biotribology. Curr Orthop. 2006;20:32–40. doi: 10.1016/j.cuor.2005.09.005. DOI

Charles MN, Bourne RB, Davey JR, Greenwald AS, Morrey BF, et al. Soft-tissue balancing of the hip: the role of femoral offset restoration. Instr Course Lect. 2005;54:131–141. PubMed

Bicanic G, Delimar D, Delimar M, Pecina M (2008) Influence of the acetabular cup position on hip load during arthroplasty in hip dysplasia. Int Orthop (in press). doi:10.1007/s00264-008-0683-z PubMed PMC

Sakalkale DP, Sharkey PF, Eng K, Hozack WJ, Rothman RH. Effect of femoral component offset on polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res. 2001;388:125–134. doi: 10.1097/00003086-200107000-00019. PubMed DOI

Roder C, Staub LP, Eichler P, Widmer M, Dietrich D, et al. Avoiding misclassification bias with the traditional Charnley classification: rationale for a fourth Charnley class BB. J Orthop Res. 2006;24:1803–1808. doi: 10.1002/jor.20224. PubMed DOI

Dumbleton JH, Manley MT, Edidin AA. A literature review of the association between wear rate and osteolysis in total hip arthroplasty. J Arthroplasty. 2002;17:649–661. doi: 10.1054/arth.2002.33664. PubMed DOI

Kim WY, Muddu BN. Eleven-year results of the ABG I hip replacement. Int Orthop. 2006;30:182–184. doi: 10.1007/s00264-006-0075-1. PubMed DOI PMC

Blacha J. High osteolysis and revision rate with the hydroxyapatite-coated ABG hip prostheses: 65 hips in 56 young patients followed for 5–9 years. Acta Orthop Scand. 2004;75:276–282. doi: 10.1080/00016470410001204. PubMed DOI

Delank KS, Drees P, Menzel N, Hansen T, Duschner H, et al. Increased polyethylene wear after cementless ABG I total hip arthroplasty. Arch Orthop Trauma Surg. 2006;126:509–516. doi: 10.1007/s00402-006-0168-8. PubMed DOI

Badhe S, Livesley P. Early polyethylene wear and osteolysis with ABG acetabular cups (7- to 12-year follow-up) Int Orthop. 2006;30:31–34. doi: 10.1007/s00264-005-0021-7. PubMed DOI PMC

Castoldi F, Rossi R, Russa M, Sibelli P, Rossi P, et al. Ten-year survivorship of the Anatomique Benoist Girard I total hip arthroplasty. J Arthroplasty. 2007;22:363–368. doi: 10.1016/j.arth.2006.05.022. PubMed DOI

Canales Cortes V, Panisello Sebastia JJ, Herrera Rodriguez A, Peguero Bona A, Martinez Martin A, et al. Ten-year follow-up of an anatomical hydroxyapatite-coated total hip prosthesis. Int Orthop. 2006;30:84–90. doi: 10.1007/s00264-005-0065-8. PubMed DOI PMC

Ingram J, Matthews JB, Tipper J, Stone M, Fisher J, et al. Comparison of the biological activity of grade GUR 1120 and GUR 415HP UHMWPE wear debris. Bio-Med Mater Eng. 2002;12:177–188. PubMed

Kurtz SM, Rimnac CM, Hozack WJ, Turner J, Marcolongo M, et al. In vivo degradation of polyethylene liners after gamma sterilization in air. J Bone Joint Surg Am. 2005;87:815–823. doi: 10.2106/JBJS.D.02111. PubMed DOI

Kurtz SM, Harrigan TP, Herr M, Manley MT. An in vitro model for fluid pressurization of screw holes in metal-backed total joint components. J Arthroplasty. 2005;20:932–938. doi: 10.1016/j.arth.2004.11.003. PubMed DOI

Particle disease really does exist

Long-term survival of the uncemented Balgrist total hip replacement cup

Male gender, Charnley class C, and severity of bone defects predict the risk for aseptic loosening in the cup of ABG I hip arthroplasty