Cross-Linked Polyethylene for Total Hip Arthroplasty Notably Reduces the Rate of Revision at 16 years

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Cross-Linked Polyethylene for Total Hip Arthroplasty Notably Reduces the Rate of Revision at 16 years

A study published in the 'The Journal of Bone and Joint Surgery' showed the significant efficacy of Cross-linked polyethylene (XLPE) in reducing the rates of revision at 16 years following total hip arthroplasty (THA) for osteoarthritis. The study outcomes may allow the younger patients to undergo surgery, confident of a decreased need for revision in the long run.

THA is a useful operation for the end-stage hip osteoarthritis management, but the wear of the polyethylene bearing surface can restrict its long-term success. In laboratory and clinical studies, the XLPE has resulted in lower wear rates and reduction in bone lysis. The present study was executed to compare the rates of revision between cross-linked polyethylene (XLPE) and conventional non-cross-linked polyethylene (CPE) at 16 years after THA for osteoarthritis.

The researchers executed an observational study of data, from a national registry, on all patients who underwent THA for osteoarthritis in Australia from 1999 to December 31, 2016. The results of THAs performed with CPE were compared with those of THAs performed with XLPE. The effect of age, sex, femoral head size, the technique of acetabular and femoral component fixation, and the reasons and types of revision was also analyzed. The primary outcome measure was defined as the time to the first revision, estimated using the Kaplan-Meier estimates of survivorship.

CPE and XLPE were used in 41,171 and 199,131 procedures. The mean age of the men and women treated with CPE were 70.0 years (standard deviation [SD] = 9.9 years) and 72.5 years (SD = 9.7 years). Men and women who obtained XLPE were slightly younger (mean age, 68.6 years [SD = 10.3 years] and 70.7 years [SD = 9.9 years], respectively. At 6 months, XLPE was found to be associated with a lower rate of revision than CPE, and this difference became more evident with time. The 16-year cumulative percentage of revisions of the primary THAs was 11.7% and 6.2% in the CPE group and XLPE group respectively. At 9 years, the hazard ratio was 3.02.

Thus, the use of XLPE has shown to significantly reduce the rate of revision at 16 years after THA for osteoarthritis.

Source

The Journal of Bone and Joint Surgery

Link to the source

https://insights.ovid.com/pubmed?pmid=30063590

The Original title of the article

Cross-Linked Polyethylene for Total Hip Arthroplasty Markedly Reduces Revision Surgery at 16 Years

Authors

R. de Steiger et al.

SearchTags: 
Exploratory, Osteoarthritis, Hip, Joint, Kaplan-Meier estimates, Observational study
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