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Polyethylene wear in cemented metal-backed acetabular cups
H E Cates1, P M Faris, E M Keating
1Center for Hip and Knee Surgery, Mooresville, Indiana 46158.
The Journal of Bone and Joint Surgery. British Volume
|March 1, 1993
Summary
Metal backing in cemented total hip arthroplasty significantly increases polyethylene wear. All-polyethylene cups are recommended to reduce wear and improve implant longevity.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Radiology
Background:
- Polyethylene wear is a primary failure mode in total hip arthroplasty.
- Acetabular cup design, specifically metal backing, may influence wear rates.
Purpose of the Study:
- To compare radiographic polyethylene wear between metal-backed and non-metal-backed acetabular cups in cemented total hip arthroplasty.
- To identify factors associated with increased polyethylene wear.
Main Methods:
- Radiographic analysis of polyethylene wear in 233 cemented total hip arthroplasties.
- Comparison of wear rates between metal-backed and non-metal-backed acetabular cups.
- Linear regression analysis to identify contributing factors to wear.
Main Results:
- Metal-backed cups showed a 37% increase in mean polyethylene wear rates compared to non-metal-backed cups.
- Mean linear wear rate was 0.11 mm/yr (metal-backed) vs. 0.08 mm/yr (non-metal-backed).
- Increased wear was associated with metal backing, male gender, and acetabular migration.
Conclusions:
- Metal backing in cemented acetabular cups leads to significantly higher polyethylene wear.
- All-polyethylene cups are advocated for cemented total hip arthroplasty to minimize wear.
- Concerns regarding wear rates of uncemented metal-backed sockets are raised.