IMPACT OF VARIOUS FACTORS ON THE POLYETHYLENE WEAR RATE IN TOTAL HIP ARTHROPLASTY

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Abstract

Purpose of the study — to determine the rate of polyethylene wear in hip arthroplasty depending on various factors and to evaluate a correlation of wear rate and motor activity of the patient.

Material and methods. 467 patients with coxarthrosis were included in the study with gender distribution of 322 (35.8%) women and 145 (31.0%) men. Mean age of patients was 55.0 years without statistically significant variances in women and men (р = 0,743). Daily motor activity of 167 patients (35.8%) was assessed using pedometer. The authors evaluated prosthesis head displacement in relation to the center of acetabulum and calculated the rate of polyethylene wear in MediCad. Modified Harris Hip Score and VAS parameters were evaluated for all patients. All data was analyzed and statistical processed.

Results. Average level of motor activity was more than 1.9 million steps per year. The overall rate of polyethylene wear depended on the follow up period, the Pearson correlation coefficient r = 0.297 (р<0,001). Mean wear rate was 0,16 mm/year (95% CI 0.15–0.17). At the same time wear rate significantly differed in the groups of standard and cross-link polyethylene, namely 0.18 mm/year (95% CI 0.17–0.19) and 0.11 mm/year (95% CI 0.1–0.11) (р<0.001). The authors identified the following additional factors affecting wear rate in the present study: cup inclination angle, r = 0.241 (р = 0.002), and the level of motor activity, r = 0.574 (р<0.001). No evident correlation of wear rate to age, r = 0.14 (р = 0.859), and to BMI, r = -0.094 (р = 0.226), was identified, which apparently is due to a strong impact of mixing factors. Patients’ satisfaction with treatment outcomes was assessed by VAS score and in average was 91,1 points (95% CI 90.3–91.9). Harris Hip Score parameters improved in average from 36.5 (95% CI 35.1–37.9) up to 91.6 points (95% CI 91.1–92.0).

Conclusion. Out of the multiple factors affecting the polyethylene wear rate only the inclination angle of acetabular component and a higher level of patient motor activity have proven to be statistically significant.

About the authors

R. M. Tikhilov

Vreden Russian Research Institute of Traumatology and Orthopedics; Mechnikov North-Western State Medical University

Email: fake@neicon.ru

Dr. Sci. (Med.), Professor, director 

professor

8, ul. Akad. Baykova, 195427, St. Petersburg

Russian Federation

M. I. Shubnyakov

Vreden Russian Research Institute of Traumatology and Orthopedics

Author for correspondence.
Email: maximtravmatolog@gmail.com

Researcher, Hip Pathology Department 

8, ul. Akad. Baykova, 195427, St. Petersburg

Russian Federation

A. A. Boyarov

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru

Researcher, Hip Pathology Department 

8, ul. Akad. Baykova, 195427, St. Petersburg

Russian Federation

A. O. Denisov

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru

Cand. Sci. (Med), Academic Secretary

8, ul. Akad. Baykova, 195427, St. Petersburg

Russian Federation

I. I. Shubnyakov

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: fake@neicon.ru

Dr. Sci. (Med.), Chief Researcher

8, ul. Akad. Baykova, 195427, St. Petersburg

Russian Federation

References

  1. Мурылев В.Ю., Елизаров П.М., Рукин Я.А., Рубин Г.Г., Куковенко Г.А. Эндопротезирование тазобедренного сустава как возможность улучшения качества жизни пациентов старческого возраста с ложным суставом шейки бедренной кости. Успехи геронтологии. 2017; 30(5):725-732. Murylev V.Ju., Elizarov P.M., Rukin Ja.A., Rubin G.G., Kukovenko G.A. [Endoprosthetics of the hip joint as an opportunity to improve the quality of life of elderly patients with a false neck of the femoral neck]. Uspehi gerontologii [Successes in gerontology]. 2017;30(5):725- 732. (in Russian).
  2. Аладышев Н.А., Ежов И.Ю. Применение коротких бедренных компонентов в эндопротезировании тазобедренного сустава. Политравма. 2017;(4):76-83. Aladyshev N.A., Ezhov I.Yu. [The use of short femoral components in hip arthroplasty]. Politravma [Polytrauma]. 2017;(4):76-83. (in Russian).
  3. Кибиткин А.С., Ксенофонтов М.А., Космынин Д.А., Абдуллаев А.К. Экспериментальное обоснование преимуществ пироуглеродной пары трения в эндопротезировании тазобедренного сустава. Вестник Пензенского государственного университета. 2017;17(1):17-21. Kibitkin A.S., Ksenofontov M.A., Kosmynin D.A., Abdullaev A.K. [Experimental substantiation of the advantages of a pyrolytic friction pair in hip joint endoprosthetics]. Vestnik Penzenskogo gosudarstvennogo universiteta [Bulletin of Penza State University]. 2017;1(17):17-21. (in Russian).
  4. Лоскутов О.А., Науменко Н.Е., Лоскутов А.Е., Синегубов Д.А., Горобец Д.В., Фурманова К.С. Оценка первичной стабильности запрессовываемого и ввинчиваемого ацетабулярных компонентов при эндопротезировании тазобедренного сустава. Ортопедия, травматология и протезирование. 2017;606(1);92-97. Loskutov O.A., Naumenko N.E., Loskutov A.E., Sinegubov D.A., Gorobec D.V., Furmanova K.S. [Evaluation of the primary stability of the pressed and screwed-in acetabular components in hip joint endoprosthetics]. Ortopedija, travmatologija i protezirovanie [Orthopedics, traumatology and prosthetics]. 2017;(1):92-97. (in Russian).
  5. Martin J.R., Jennings J.M., Watters T.S., Levy D.L., Miner T.M., Dennis D.A. Midterm Prospective Comparative Analysis of 2 Hard-on-Hard Bearing Total Hip Arthroplasty Designs. J Arthroplasty. 2018 Jan 31. pii: S0883-5403(18)30056-1. doi: 10.1016/j.arth.2018.01.019. [Epub ahead of print].
  6. Lachiewicz P.F., Kleeman L.T., Seyler T. Bearing Surfaces for Total Hip Arthroplasty. J Am Acad Orthop Surg. 2018;15;26(2):45-57. doi: 10.5435/JAAOS-D-15-00754.
  7. Heckmann N.D., Sivasundaram L., Stefl M.D., Kang H.P., Basler E.T., Lieberman J.R. Total Hip Arthroplasty Bearing Surface Trends in the United States From 2007 to 2014: The Rise of Ceramic on Polyethylene. J Arthroplasty. 2018 Jan 9. pii: S0883-5403(18)30002-0. doi: 10.1016/j.arth.2017.12.040. [Epub ahead of print].
  8. Шубняков И.И., Тихилов Р.М., Николаев Н.С., Григоричева Л.Г., Овсянкин А.В., Черный А.Ж., Дроздова П.В., Денисов А.О., Вебер Е.В., Кузьмина И.В. Эпидемиология первичного эндопротезирования тазобедренного сустава на основании данных регистра артропластики РНИИТО им. Р.Р. Вредена. Травматология и ортопедия России. 2017;23(2):81-101. doi: 10.21823/2311-2905-2017-23-2-81-101. Shubnyakov I.I., Tikhilov R.M., Nikolaev N.S., Grigoricheva L.G., Ovsyankin A.V., Cherny A.Z., Drozdova P.V., Denisov A.O., Veber Е.V., Kuz’mina I.V. Epidemiology of primary hip arthroplasty: report from register of Vreden Russian Research Institute of Traumatology and Orthopedics. Travmatologiya i ortopediya Rossii [Traumatology and Orthopedics of Russia]. 2017;23(2):81-101. (in Russian). doi: 10.21823/2311-2905-2017-23-2-81-101.
  9. Hoskins W., van Bavel D., Lorimer M., de Steiger R.N. Polished cemented femoral stems have a lower rate of revision than matt finished cemented stems in total hip arthroplasty: an analysis of 96,315 cemented femoral stems. J Arthroplasty. 2017 Dec 13. pii: S0883- 5403(17)31090-2. doi: 10.1016/j.arth.2017.12.002. [Epub ahead of print].
  10. Petsatodis G.E., Papadopoulos P.P., Papavasiliou K.A., Hatzokos I.G., Agathangelidis F.G., Christodoulou A.G. Primary cementless total hip arthroplasty with an alumina ceramic-on-ceramic bearing: results after a minimum of twenty years of follow-up. J Bone Joint Surg Am. 2010;92(3):639-644. doi: 10.2106/JBJS.H.01829.
  11. Stefl M.D., Callaghan J.J., Liu S.S., Pedersen D.R., Goetz D.D., Johnston R.C. Primary cementless acetabular fixation at a minimum of twenty years of follow-up: a concise update of a previous report. J Bone Joint Surg Am. 2012;94(3):234-239. doi: 10.2106/JBJS.K.00237.
  12. Warth L.C., Callaghan J.J., Liu S.S., Klaassen A.L., Goetz D.D., Johnston R.C. Thirty-five-year results after Charnley total hip arthroplasty in patients less than fifty years old. A concise follow-up of previous reports. J Bone Joint Surg Am. 2014;96(21):1814-1819. doi: 10.2106/JBJS.M.01573.
  13. Хрыпов С.В., Красавина Д.А., Веселов А.Г. Эндопротезирование тазобедренного сустава при лечении вторичного коксартроза различного генеза у детей старшего возраста. Педиатр. 2017;8(S):М347. Hrypov S.V., Krasavina D.A., Veselov A.G. [Endoprosthetics of the hip joint in the treatment of secondary coxarthrosis of various genesis in older children]. Pediatr [Pediatrician]. 2017;8(S):347. (in Russian).
  14. Козлов А.С., Кузин А.С., Махров Л.А., Моисеев С.Н., Трубин И.В. Эндопротезирование тазобедренного сустава у детей и подростков. Московская медицина. 2016;S1(12):129-130. Kozlov A.S., Kuzin A.S., Makhrov L.A., Moiseev S.N., Trubin I.V. [Endoprosthetics of the Hip Joint in Children and Adolescents]. Moskovskaya medisina [Moscow medicine]. 2016;S1(12):129-130. (in Russian).
  15. Van de Velde S.K., Loh B., Donnan L. Total hip arthroplasty in patients 16 years of age or younger. J Child Orthop. 2017;11(6):428-433. doi: 10.1302/1863-2548.11.170085.
  16. Шубняков И.И., Тихилов Р.М., Гончаров М.Ю., Карпухин А.С., Мазуренко А.В., Плиев Д.Г., Близнюков В.В. Достоинства и недостатки современных пар трения эндопротезов тазобедренного сустава (обзор иностранной литературы). Травматология и ортопедия России. 2010;(3):147-156. doi: 10.21823/2311-2905-2010-0-3-147-156. Shubnyakov I.I., Tikhilov R.M., Goncharov M.Y., Karpukhin A.S., Mazurenko A.V., Pliev D.G., Bliznyukov V.V. Merits and Demerits of Modern Bearing Surfaces of Hip Implants (Review of Foreign Literature). Travmatologiya i ortopediya Rossii [Traumatology and Orthopedics of Russia]. 2010;(3):147-156. (in Russian). doi: 10.21823/2311-2905-2010-0-3-147-156.
  17. Atrey A., Ward S.E., Khoshbin A., Hussain N., Bogoch E., Schemitsch E.H., Waddell J.P. Ten-year follow-up study of three alternative bearing surfaces used in total hip arthroplasty in young patients: a prospective randomised controlled trial. Bone Joint J. 2017;99-B(12):1590-1595. doi: 10.1302/0301-620X.99B12.BJJ-2017-0353.R1.
  18. Devane P.A., Horne J.G., Ashmore A., Mutimer J., Kim W., Stanley J. Highly cross-linked polyethylene reduces wear and revision rates in total hip arthroplasty: A 10-year double-blinded randomized controlled trial. J Bone Joint Surg Am. 2017;99(20):1703-1714. doi: 10.2106/JBJS.16.00878.
  19. Тихилов Р.М., Шубняков М.И., Шубняков И.И., Сивков В.С., Малыгин Р.В., Цыбин А.В., Любчак В.В. Двигательная активность пациентов молодого возраста после эндопротезирования тазобедренного сустава. Современные проблемы науки и образования. 2018;(1):66. Tikhilov R.M., Shubnyakov M.I., Shubnyakov I.I., Sivkov V.S., Malygin R.V., Tsybin A.V., Lyubchak V.V. [Motor activity of young patients after total hip arthroplasty]. Sovremennye problemy nauki i obrazovaniya [Modern problems of science and education]. 2018;(1):66. (in Russian).
  20. Liang T.J., You M.Z., Xing P.F., Bin S., Ke Z.Z., Jing Y. Uncemented total hip arthroplasty in patients younger than 50 years: a 6- to 10-year follow-up study. Orthopedics. 2010;33(4). doi: 10.3928/01477447-20100225-18.
  21. Martin C.T., Callaghan J.J., Gao Y., Pugely A.J., Liu S.S., Warth L.C., Goetz D.D. What can we learn from 20-year followup studies of hip replacement? Clin Orthop Relat Res. 2016;474(2):402-407. doi: 10.1007/s11999-015-4260-7.
  22. Kuhn M., Harris-Hayes M., Steger-May K., Pashos G., Clohisy J.C. Total hip arthroplasty in patients 50 years or less: do we improve activity profiles? J Arthroplasty. 2013;28(5):872-876. doi: 10.1016/j.arth.2012.10.009.
  23. Sechriest V.F. 2nd, Kyle R.F., Marek D.J., Spates J.D., Saleh K.J., Kuskowski M. Activity level in young patients with primary total hip arthroplasty: a 5-year minimum follow-up. J Arthroplasty. 2007;22(1):39-47. doi: 10.1016/j.arth.2006.02.083.
  24. Greiner J.J., Callaghan J.J., Bedard N.A., Liu S.S., Gao Y., Goetz D.D. Fixation and wear with contemporary acetabular components and cross-linked polyethylene at 10-years in patients aged 50 and under. J Arthroplasty. 2015;30(9):1577-1585. doi: 10.1016/j.arth.2015.05.011.
  25. Cash D.J., Khanduja V. The case for ceramic-onpolyethylene as the preferred bearing for a young adult hip replacement. Hip Int. 2014;24(5):421-427. doi: 10.5301/hipint.5000138.
  26. Тихилов Р.М., Шубняков И.И., Плиев Д.Г., Богопольский О.Е., Гуацаев М.С. Возможности рентгенографии в ранней диагностике патологии тазобедренного сустава. Травматология и ортопедия России. 2017;23(1):117-131. doi: 10.21823/2311-2905-2017-23-1-117-131. Tikhilov R.M., Shubnyakov I.I., Pliev D.G., Bogopol’skii O.E., Guatsaev M.S. [Possibilities of radiography in the early diagnosis of hip joint pathology]. Travmatologiya i ortopediya Rossii [Traumatology and orthopedics in Russia]. 2017;23(1):117-131. (in Russian). doi: 10.21823/2311-2905-2017-23-1-117-131.
  27. Gallo J., Slouf M., Goodman S.B. The relationship of polyethylene wear to particle size, distribution, and number: A possible factor explaining the risk of osteolysis after hip arthroplasty. J Biomed Mater Res B Appl Biomater. 2010;94(1):171-177. doi: 10.1002/jbm.b.31638.
  28. Kinkel S., Wollmerstedt N., Kleinhans J.A., Hendrich C., Heisel C. Patient activity after total hip arthroplasty declines with advancing age. Clin Orthop Relat Res. 2009;467(8):2053-2058. doi: 10.1007/s11999-009-0756-3.
  29. Pokorný D., Slouf M., Veselý F., Fulín P., Jahoda D., Sosna A. Distribution of UHMWPE wear particles in periprosthetic tissues of total hip replacements. Acta Chir Orthop Traumatol Cech. 2010;77(2):87-92.
  30. Schmalzried T.P., Shepherd E.F., Dorey F.J., Jackson W.O., dela Rosa M., Fa’vae F. et al. Wear is a function of use, not time. Clin Orthop Relat Res. 2000;(381):36-46.
  31. Jiang H., Wang Y., Deng Z., Jin J., Meng J., Chen S. et al. Construction and evaluation of a murine calvarial osteolysis model by exposure to cocrmo particles in aseptic loosening. J Vis Exp. 2018;(132). doi: 10.3791/56276.
  32. Gaudiani M.A., White P.B., Ghazi N., Ranawat A.S., Ranawat C.S. Wear rates with large metal and ceramic heads on a second generation highly cross-linked polyethylene at mean 6-year follow-up. J Arthroplasty. 2018;33(2):590-594. doi: 10.1016/j.arth.2017.09.006.
  33. Samujh C., Bhimani S., Smith L., Malkani A.L. Wear analysis of second-generation highly cross-linked polyethylene in primary total hip arthroplasty. Orthopedics. 2016;39(6):e1178-e1182. doi: 10.3928/01477447-20160808-02.
  34. Choi W.K., Kim J.J., Cho M.R. Results of total hip arthroplasty with 36-mm metallic femoral heads on 1st generation highly cross linked polyethylene as a bearing surface in less than forty year-old patients: minimum ten-year results. Hip pelvis. 2017;29(4):223-227. doi: 10.5371/hp.2017.29.4.223.
  35. Hopper R.H. Jr, Ho H., Sritulanondha S., Williams A.C., Engh C.A. Jr. Otto Aufranc Award: crosslinking reduces tha wear, osteolysis, and revision rates at 15-year followup compared with noncrosslinked polyethylene. Clin Orthop Relat Res. 2018;476(2):279-290. doi: 10.1007/s11999.0000000000000036.
  36. Тураходжаев Ф.А., Магомедов Х.М., Калашников С.А., Загородний Н.В. Эндопротезирование тазобедренного сустава c применением пары трения керамика- поперечносвязанный полиэтилен сроком наблюдения 10 лет. Вестник Российского научного центра рентгенорадиологии Минздрава России. 2016; 16(3):5. Turakhodzhaev F.A., Magomedov Kh.M., Kalashnikov S.A., Zagorodnii N.V. [Total hip artroplasty using a pair of friction ceramic-cross-linked polyethylene observation period of 10 years]. Vestnik Rossijskogo nauchnogo centra rentgenoradiologii Minzdrava Rossii [Bulletin of the Russian Scientific Center of Roentgenoradiology of the Ministry of Health of Russia]. 2016;16(3):5. (in Russian).
  37. Morrison T.A., Moore R.D., Meng J., Rimnac C.M., Kraay M.J. No difference in conventional polyethylene wear between yttria-stabilized zirconia and cobaltchromium-molybdenum femoral heads at 10 years. HSS J. 2018;14(1):60-66. doi: 10.1007/s11420-017-9579-z.
  38. Hernigou P., Roubineau F., Bouthors C., FlouzatLachaniette C.H. What every surgeon should know about Ceramic-on-Ceramic bearings in young patients. EFFORT Open Rev. 2017;1(4):107-111. doi: 10.1302/2058-5241.1.000027.
  39. Morscher E.W. Failures and successes in total hip replacement – why good ideas may not work. Scand J Surg. 2003;92(2):113-20. doi: 10.1177/145749690309200202.

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