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Total hip replacement using a highly crosslinked polyethylene liner in Asians with small acetabulum
Weiliang Chua1, Shuvendu Roy, Jonathan Sng
1National University Hospital, Singapore.
Journal of Orthopaedic Surgery (Hong Kong)
|January 1, 2015
Summary
This study shows that thin highly cross-linked polyethylene (HXLPE) liners in total hip replacement (THR) are safe for Asian patients. Medium-term results indicate good outcomes with minimal wear, suggesting HXLPE is a viable option for small acetabulums.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Medical Engineering
Background:
- Total hip replacement (THR) is a common procedure for hip joint diseases.
- Highly cross-linked polyethylene (HXLPE) liners offer improved wear resistance compared to traditional materials.
- Thin HXLPE liners are particularly relevant for patients with smaller acetabular components.
Purpose of the Study:
- To evaluate the medium-term clinical and radiographic outcomes of primary total hip replacement (THR) utilizing thin highly cross-linked polyethylene (HXLPE) liners.
- To assess the safety and efficacy of this implant combination in an Asian demographic.
- To determine the rate of femoral head penetration and correlate it with various surgical and patient factors.
Main Methods:
- A retrospective review of 80 total hip replacements (THRs) performed using thin HXLPE liners in 64 patients (20 men, 44 women) aged 26–80 years.
- Indications included hip dysplasia, avascular necrosis, osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis.
- Radiographic evaluation included assessment of cup migration, peri-implant radiolucency, and measurement of femoral head penetration using established methods (Kang modification of Dorr and Wan, PowerPoint method) at baseline and follow-up.
Main Results:
- After a mean follow-up of 7.5 years, no acetabular revisions were required; two femoral stem revisions occurred.
- Femoral head penetration rates were low, with a maximum of 0.09 mm/year, below the osteolysis threshold of 0.1 mm/year.
- Mean femoral head penetration was 0.04 ± 0.02 mm/year (PowerPoint) and 0.02 ± 0.03 mm/year (Kang modification), correlating significantly with follow-up duration but not with other assessed variables.
Conclusions:
- Thin highly cross-linked polyethylene (HXLPE) liners demonstrate favorable medium-term outcomes in primary total hip replacement (THR).
- This implant choice is effective for Asian patients, particularly those with small acetabular components.
- The low wear rates suggest good implant durability and a reduced risk of osteolysis.
