Rim cracking of the cross-linked longevity polyethylene acetabular liner after total hip arthroplasty.
نویسندگان
چکیده
BACKGROUND Studies have suggested that cross-linked polyethylene bearings reduce wear rates from 40% to 100% compared with conventional polyethylene. However, the reduced mechanical properties of highly cross-linked polyethylene have the potential to be a limiting factor in device performance. We reviewed a series of retrieved acetabular liners with a fracture of the superior rim to assess the factors that played a role in their failure. METHODS Four Longevity acetabular bearings, which had been retrieved from two patients after seven to twenty-seven months in vivo, were visually examined for clinical damage, were assessed with use of Fourier transform infrared spectroscopy to determine the level of oxidation, and were analyzed for mechanical properties and fracture surface characterization. Control data were obtained from never-implanted devices and from global reference ultrahigh molecular weight polyethylene bar stock as an industry calibration material. RESULTS All four retrieved liners demonstrated articular surface wear modes, which in most cases were rated as moderate, and none were rated as severe. All showed cracking or rim failure of the liner at the superior aspect along the groove in the polyethylene that engages the locking ring of the shell. The retrieved liners had no measurable oxidation, and the mechanical properties were comparable with those of never-implanted material. CONCLUSIONS There was no notable in vivo degradation of the retrieved liners. Important factors related to failure appear to be thin polyethylene at the cup rim, relatively vertical cup alignment, and the material properties of the highly cross-linked polyethylene that are decreased relative to conventional polyethylene. The critical dimension with respect to rim failure in modular liners appears to be the minimum thickness at the equatorial region.
منابع مشابه
Catastrophic Failure of the Acetabular Polyethylene Liner in Ceramic-on-Polyethylene Total Hip Arthroplasty
INTRODUCTION Catastrophic polyethylene failure is a rare complication of ceramic-on-polyethylene total hip arthroplasty due to the favorable tribological characteristics of ceramic. Failure of the polyethylene liner can be disastrous, increasing periprosthetic osteolysis, metallosis, and risk of dislocation. Complications associated with ceramic-on-polyethylene articulations have been studied e...
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BACKGROUND 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 ...
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Incarcerated fracture fragments of Longevity polyethylene liners after total hip arthroplasty
Highly cross-linked polyethylene liners are widely used in total hip arthroplasty because they experience lower wear rates than conventional polyethylene liners. However, the cross-linking process does decrease the resistance of polyethylene to fatigue failure and fracture. This report describes 2 cases of highly cross-linked polyethylene liner fracture occurring in association with hip disloca...
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ورودعنوان ژورنال:
- The Journal of bone and joint surgery. American volume
دوره 89 10 شماره
صفحات -
تاریخ انتشار 2007