Abstract：
BACKGROUND: There is a paucity of data beyond 15 years on the survivorship of total hip arthroplasty since the introduction of highly cross-linked polyethylene (HXLPE) liners. Our aim was to evaluate implant survivorship, liner wear rates, and clinical outcomes after primary total hip arthroplasty using HXLPE liners implanted between 1999 and 2002.
METHODS: Between 1999 and 2002, 690 primary total hip arthroplasties utilizing 28-mm femoral heads and HXLPE liners of a single design were identified using our institutional total joint registry. Femoral heads were made of metal in 96% of cases and ceramic in 4%. The mean age was 56 years, 48% were women, and the mean body mass index was 30. Survivorship analyses were performed for the outcomes of implant revision, reoperation, and complications for the entire cohort. Linear HXLPE liner wear rates were determined on 197 hips with radiographs with more than 18.5 years of follow-up.
RESULTS: At 20 years, survivorship free of revision was 94%, free of reoperation was 92%, and free of any complication was 81%. There were no documented wear-related revisions. The linear wear rate at a mean of 20.3 years postoperatively was 0.02 mm/y. There was no statistically significant difference in measured wear observed between the first available postoperative radiographs and those taken at the final follow-up. The use of elevated liners, patient body mass index, age, preoperative diagnosis, acetabular component inclination, and anteversion angles were not associated with increased wear rates. Mean Harris hip scores improved from 52 preoperatively to 90 at greater than 18.5 years CONCLUSIONS: Primary total hip arthroplasties using a single first-generation HXLPE liner demonstrated excellent survivorship and clinical outcomes at long-term follow-up with no wear-related revisions. Wear rates of HXLPE liners at 20 years are exceedingly low and are not significantly impacted by acetabular component position or patient-dependent variables such as BMI.
METHODS: IV.
METHODS: Between 1999 and 2002, 690 primary total hip arthroplasties utilizing 28-mm femoral heads and HXLPE liners of a single design were identified using our institutional total joint registry. Femoral heads were made of metal in 96% of cases and ceramic in 4%. The mean age was 56 years, 48% were women, and the mean body mass index was 30. Survivorship analyses were performed for the outcomes of implant revision, reoperation, and complications for the entire cohort. Linear HXLPE liner wear rates were determined on 197 hips with radiographs with more than 18.5 years of follow-up.
RESULTS: At 20 years, survivorship free of revision was 94%, free of reoperation was 92%, and free of any complication was 81%. There were no documented wear-related revisions. The linear wear rate at a mean of 20.3 years postoperatively was 0.02 mm/y. There was no statistically significant difference in measured wear observed between the first available postoperative radiographs and those taken at the final follow-up. The use of elevated liners, patient body mass index, age, preoperative diagnosis, acetabular component inclination, and anteversion angles were not associated with increased wear rates. Mean Harris hip scores improved from 52 preoperatively to 90 at greater than 18.5 years CONCLUSIONS: Primary total hip arthroplasties using a single first-generation HXLPE liner demonstrated excellent survivorship and clinical outcomes at long-term follow-up with no wear-related revisions. Wear rates of HXLPE liners at 20 years are exceedingly low and are not significantly impacted by acetabular component position or patient-dependent variables such as BMI.
METHODS: IV.
摘要：
背景：自引入高度交联聚乙烯（HXLPE）衬垫以来，缺乏超过15年的全髋关节置换术生存率数据。我们的目的是评估植入物的存活率，衬垫磨损率，以及1999年至2002年间使用HXLPE衬垫植入的原发性THA后的临床结果。
方法：在1999年至2002年之间，使用我们的机构全关节注册表确定了690种使用28毫米股骨头和单一设计的HXLPE衬垫的主要THA。96％的病例股骨头由金属制成，4％的病例由陶瓷制成。平均年龄是56岁,48%是女性,平均BMI为30。对植入物翻修的结果进行了生存分析，再操作,和整个队列的并发症。在超过18.5年的随访中，用X射线照片确定了197臀部的线性HXLPE衬垫磨损率。
结果：20年后，无修订生存率为94%，无再次手术率是92%，无任何并发症的占81%。没有记录与磨损相关的修订。术后平均20.3年的线性磨损率为0.02mm/年。在首次可用的术后X光片和最终随访时观察到的测量磨损没有统计学上的显着差异。使用高架衬垫，患者BMI,年龄,术前诊断,髋臼部件倾斜度,和前倾角与增加的磨损率无关。Harris髋关节平均评分从术前的52提高到超过18.5年的90。
结论：使用第一代HXLPE衬垫的原发性THA在长期随访中表现出优异的生存率和临床结果，没有磨损相关的修订。HXLPE衬垫在20年时的磨损率非常低，并且不会受到髋臼部件位置或患者相关变量如BMI的显著影响。
方法：IV.
方法：在1999年至2002年之间，使用我们的机构全关节注册表确定了690种使用28毫米股骨头和单一设计的HXLPE衬垫的主要THA。96％的病例股骨头由金属制成，4％的病例由陶瓷制成。平均年龄是56岁,48%是女性,平均BMI为30。对植入物翻修的结果进行了生存分析，再操作,和整个队列的并发症。在超过18.5年的随访中，用X射线照片确定了197臀部的线性HXLPE衬垫磨损率。
结果：20年后，无修订生存率为94%，无再次手术率是92%，无任何并发症的占81%。没有记录与磨损相关的修订。术后平均20.3年的线性磨损率为0.02mm/年。在首次可用的术后X光片和最终随访时观察到的测量磨损没有统计学上的显着差异。使用高架衬垫，患者BMI,年龄,术前诊断,髋臼部件倾斜度,和前倾角与增加的磨损率无关。Harris髋关节平均评分从术前的52提高到超过18.5年的90。
结论：使用第一代HXLPE衬垫的原发性THA在长期随访中表现出优异的生存率和临床结果，没有磨损相关的修订。HXLPE衬垫在20年时的磨损率非常低，并且不会受到髋臼部件位置或患者相关变量如BMI的显著影响。
方法：IV.
