Hip Resurfacing Using Highly Cross-linked Polyethylene: Prospective Study Results at 8.5 Years

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• 作者：James W. Pritchett ; MD
• 关键词：hip resurfacing ; highly cross-linked polyethylene ; implant survivorship ; polyethylene wear ; conservative hip implant arthroplasty
• 刊名：The Journal of Arthroplasty
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：31
• 期：10
• 页码：2203-2208
• 全文大小：682 K

文摘

Hip resurfacing is an option to consider when treating younger, more active patients. Advantages over total hip arthroplasty include a more normal gait and a lower incidence of thigh pain.

Methods

In this prospective study, 190 hip resurfacing procedures (164 participants) were performed using a cobalt-chromium femoral component and a cementless acetabular cup with a 3.8-mm highly cross-linked polyethylene acetabular liner.

Results

The mean follow-up was 8.5 (range, 7-10) years. Two participants were lost to follow-up and 2 died. One participant underwent successful revision surgery for acetabular loosening. Four participants underwent successful revision to a total hip arthroplasty because of femoral neck fracture (2), femoral loosening, or infection. The Kaplan-Meier survivorship was 97%. Acetabular bone conservation was assessed using computed tomography by measuring the medial acetabular wall. The mean thickness was 9 mm. Femoral bone was well preserved with a mean head:neck ratio of 1.37. There were 4 (2%) osteolytic defects up to 0.9 cm³ on computed tomography and no instances of impending polyethylene wear-through. Seven polyethylene retrievals had a measured wear rate of 0.05 mm/y.

Conclusion

Hip resurfacing using a highly cross-linked polyethylene acetabular component is a reliable procedure. Both femoral and acetabular bones are reasonably preserved compared with prior resurfacing methods. The low incidence of osteolysis and the low rate of wear found on retrievals suggest that many years of use in highly active patients is possible.