Polyethylene wear and cup migration of cemented total hip arthroplasty with femoral heads made of oxidized zirconium, steel, or cobalt chromium: a 10-year secondary analysis from a randomized trial using radiostereometry.

IF 2.5 2区医学 Q1 ORTHOPEDICS Acta Orthopaedica Pub Date : 2024-09-30 DOI:10.2340/17453674.2024.41945

Håkon Greve Johannessen, Geir Hallan, Thomas Kadar, Anne Marie Fenstad, Stein Håkon Låstad Lygre, Kristin Haugan, Paul Johan Høl, Mona Badawy, Benedikt Jonsson, Kari Indrekvam, Arild Aamodt, Ove Furnes

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Abstract

Background and purpose: We aimed to evaluate polyethylene (PE) wear, cup migration, and clinical outcome over 10 years in total hip arthroplasties (THA) using different articulations.

Methods: This is a secondary analysis of 150 patients randomized into 5 groups, using different articulations: Charnley/Charnley Ogee for steel and conventional polyethylene (CPE), or Spectron EF/Reflection with either CPE or highly cross linked polyethylene (XLPE) cups, paired with heads made of either cobalt-chromium (CoCr) or oxidized zirconium (OxZr). All cups were cemented. Patients underwent repeated radiostereometric analysis (RSA) measurements for up to 10 years to assess wear and migration. Clinical outcome was assessed using Harris Hip Score (HHS).

Results: After 10 years, the XLPE cups demonstrated low wear rates: 0.08 mm (95% confidence interval [CI] -0.11 to 0.26 mm) with CoCr heads and 0.06 mm (CI -0.14 to 0.26 mm) with OxZr heads, with a mean difference of 0.01 mm (CI -0.26 to 0.29 mm). In contrast, CPE cups exhibited significantly more wear: 1.35 mm (CI 1.16 to 1.55 mm) with CoCr heads and 1.68 mm (CI 1.44 to 1.92 mm) with OxZr heads, with a mean difference of 0.33 mm (CI 0.02 to 0.64 mm). The Charnley/Ogee group (CPE) showed PE wear of 0.34 mm (CI 0.12 to 0.56 mm). The CPE groups with OxZr and CoCr heads had 0.67 mm (CI 0.38 to 0.96 mm) and 0.35 mm (CI 0.09 to 0.61 mm) greater proximal migration respectively than the corresponding XLPE groups. HHS was similar across all groups.

Conclusion: We found no significant advantage of OxZr over CoCr heads in reducing wear or migration. XLPE demonstrated a major reduction in wear as well as a reduction in cup migration compared with CPE. Charnley performed better than the other CPE cups in terms of PE wear and cup migration. No differences in clinical outcome were found.

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使用氧化锆、钢或钴铬股骨头的骨水泥全髋关节置换术的聚乙烯磨损和髋臼杯移位：使用放射线测量法对随机试验进行的为期 10 年的二次分析。

背景和目的：我们的目的是评估使用不同关节的全髋关节置换术（THA）10年来的聚乙烯（PE）磨损、髋臼杯移位和临床疗效：这是对随机分为5组、采用不同关节的150名患者进行的二次分析：方法：这是对150名患者进行的二次分析，随机分为5组，采用不同的关节连接方式：钢和传统聚乙烯（CPE）的Charnley/Charnley Ogee，或使用CPE或高交联聚乙烯（XLPE）髋臼杯的Spectron EF/Reflection，配以钴铬（CoCr）或氧化锆（OxZr）制成的髋臼头。所有髋臼杯均采用骨水泥固定。患者在长达10年的时间里反复接受放射性立体计量分析（RSA）测量，以评估磨损和移位情况。临床结果采用哈里斯髋关节评分（HHS）进行评估： 10年后，XLPE髋臼杯的磨损率很低，仅为0.08毫米（95%置信区间）：结果：10年后，XLPE髋臼杯的磨损率较低：钴铬合金头为0.08毫米（95%置信区间[CI]-0.11至0.26毫米），OxZr头为0.06毫米（CI-0.14至0.26毫米），平均差异为0.01毫米（CI-0.26至0.29毫米）。相比之下，CPE髋臼杯的磨损明显更严重：钴铬合金头磨损1.35毫米（CI值为1.16至1.55毫米），OxZr头磨损1.68毫米（CI值为1.44至1.92毫米），平均差异为0.33毫米（CI值为0.02至0.64毫米）。Charnley/Ogee组（CPE）的PE磨损为0.34毫米（CI为0.12至0.56毫米）。与相应的 XLPE 组相比，带有 OxZr 和 CoCr 头的 CPE 组的近端移位分别大 0.67 毫米（CI 0.38 至 0.96 毫米）和 0.35 毫米（CI 0.09 至 0.61 毫米）。各组的 HHS 相似：我们发现，与钴铬合金头相比，OxZr在减少磨损或移位方面没有明显优势。与 CPE 相比，XLPE 在减少磨损和减少髋臼杯移位方面表现突出。在PE磨损和杯体移位方面，Charnley比其他CPE杯表现更好。在临床结果方面没有发现差异。

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来源期刊

Acta Orthopaedica 医学-整形外科

CiteScore

6.40

自引率

8.10%

发文量

105

审稿时长

4-8 weeks

期刊介绍： Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.