This contribution lays the foundation for the European database of explanted UHMWPE liners from total joint replacements. Three EU countries (Czech Republic, Italy and Spain) have joined their datasets containing anonymized patient data (such as age and BMI), manufacturer data (such as information on UHMWPE crosslinking, thermal treatment and sterilization), orthopedic evaluation (such as total duration of the implant in vivo and reasons for its revision) and material characterization (such as oxidative degradation and micromechanical properties). The joined database contains more than 500 entries, exhibiting gradual growth, and it is beginning to show interesting trends, which are discussed in our contribution, including (i) strong correlations between UHMWPE oxidative degradation, degree of crystallinity and microhardness; (ii) statistically significant differences between UHMWPE liners with different types of sterilization; (iii) realistic correlations between the extent of oxidative degradation and the observed reasons for total joint replacement failures. Our final objective and task for the future is to continuously expand the database, involving researchers from other European countries, in order to create a robust tool that will contribute to the better understanding of structure-properties-performance relationships in the field of arthroplasty implants.

• Klíčová slova
• European database, UHMWPE, micromechanical properties, oxidative degradation, retrieval study, total joint replacements, ultrahigh molecular weight polyethylene,
• Publikační typ
• časopisecké články MeSH

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.

• MeSH
• acetabulum patologie   chirurgie   MeSH
• dospělí MeSH
• hlavice femuru patologie   chirurgie   MeSH
• kyčelní kloub patofyziologie   chirurgie   MeSH
• kyčelní protézy MeSH
• lidé středního věku MeSH
• lidé MeSH
• logistické modely MeSH
• mechanický stres MeSH
• náhrada kyčelního kloubu škodlivé účinky   MeSH
• odds ratio MeSH
• osteolýza epidemiologie   etiologie   patologie   MeSH
• polyethylen MeSH
• protézy - design MeSH
• reoperace MeSH
• rizikové faktory MeSH
• selhání protézy MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• polyethylen MeSH