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Journal article
History and Systematic Review of Wear and Osteolysis Outcomes for First-generation Highly Crosslinked Polyethylene
Clinical orthopaedics and related research, v 469(8), pp 2262-2277
01 Aug 2011
PMID: 21431461
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Highly crosslinked polyethylene (HXLPE) was introduced to reduce wear and osteolysis in total joint arthroplasty. While many studies report wear and osteolysis associated with HXLPE, analytical techniques, clinical study design and followup, HXLPE formulation and implant design characteristics, and patient populations differ substantially among investigations, complicating a unified perspective.
Literature on first-generation HXLPE was summarized. We systematically reviewed the radiographic wear data and incidence of osteolysis for HXLPE in hip and knee arthroplasty.
PubMed identified 391 studies; 28 met inclusion criteria for a weighted-averages analysis of two-dimensional femoral head penetration rates. To determine the incidence of osteolysis, we estimated a pooled odds ratio using a random-effects model.
Weighted-averages analyses of femoral head penetration rates in HXLPE liners and conventional UHMWPE liners resulted, respectively, in a mean two-dimensional linear penetration rate of 0.042 mm/year based on 28 studies (n = 1503 hips) and 0.137 mm/year based on 18 studies (n = 695 hips). The pooled odds ratio for the risk of osteolysis in HXLPE versus conventional liners was 0.13 (95% confidence interval, 0.06-0.27) among studies with minimum 5-year followup. We identified two clinical studies of HXLPE in TKA, preventing systematic analysis of outcomes.
HXLPE liner studies consistently report lower femoral head penetration and an 87% lower risk of osteolysis. Reduction in femoral head penetration or osteolysis risk is not established for large-diameter (> 32 mm) metallic femoral heads or ceramic femoral heads of any size. Few studies document the clinical performance of HXLPE in knees.
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Details
- Title
- History and Systematic Review of Wear and Osteolysis Outcomes for First-generation Highly Crosslinked Polyethylene
- Creators
- Steven M. Kurtz - Drexel UniversityHeather A. Gawel - Drexel UniversityJasmine D. Patel - Drexel University
- Publication Details
- Clinical orthopaedics and related research, v 469(8), pp 2262-2277
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 16
- Grant note
- R01AR047904 / NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) Stryker Orthopaedics, Inc (Mahwah, NJ) R01 AR47904 / National Institutes of Health (NIAMS); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) StelKast (McMurray, PA) Zimmer, Inc (Warsaw, IN) R01NS056222 / NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- School of Biomedical Engineering, Science, and Health Systems
- Web of Science ID
- WOS:000292271700018
- Scopus ID
- 2-s2.0-79960969639
- Other Identifier
- 991019167438104721
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- Web of Science research areas
- Orthopedics
- Surgery