Document Detail

The incidence of acetabular osteolysis in young patients with conventional versus highly crosslinked polyethylene.
MedLine Citation:
PMID:  20824407     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Osteolysis is a major mode of hip implant failure. Previous literature has focused on the amount of polyethylene wear comparing highly crosslinked polyethylene (HXPLE) with conventional liners but has not clarified the relative incidence of osteolysis with these two liners.
QUESTIONS/PURPOSES: We determined (1) the incidence of osteolysis in HXLPE versus conventional polyethylene (CPE), (2) the ability to detect and evaluate the size of lytic lesions using radiographs compared with CT scans, (3) head penetration in hips without and with lysis, and (4) determined whether acetabular position, head size, and UCLA activity score contributed to lysis.
METHODS: We compared head penetration and osteolysis on plain radiographs and presence and volume of osteolysis on CT scans in 48 patients with HXLPE (mean, 46.5 years) and 50 patients with CPE (mean, 43.2 years). The minimum followup was 5 years (average, 7.2 years; range, 5.1-10.9 years),
RESULTS: Osteolysis was apparent on CT in a larger number of patients with CPE liners than HXLPE liners: 12 of 50 (24%) versus one of 48 (2%), respectively. We found no correlation between head penetration and volume of osteolytic lesions. Head penetration was greater in patients with osteolysis. Smaller head sizes were associated with greater wear and those with osteolysis had smaller head sizes; however, there was no difference in acetabular component position or UCLA activity in those with lysis compared with those without.
CONCLUSIONS: HXLPE diminished the incidence of osteolysis, but the lack of correlation between penetration and volume of osteolysis suggests other factors other than wear contribute to the development of osteolysis.
LEVEL OF EVIDENCE: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Nathan A Mall; Ryan M Nunley; Jin Jun Zhu; William J Maloney; Robert L Barrack; John C Clohisy
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-11     Completed Date:  2011-02-24     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  372-81     Citation Subset:  AIM; IM    
Department of Orthopedics, Washington University School of Medicine, Barnes-Jewish Hospital, One Barnes-Jewish Hospital Plaza, 11300 West Pavilion, St Louis, MO 63110, USA.
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MeSH Terms
Acetabulum / pathology*
Arthroplasty, Replacement, Hip / instrumentation*
Cross-Linking Reagents
Equipment Failure Analysis
Femur Head / pathology,  radiography
Hip Joint / pathology*,  surgery
Hip Prosthesis*
Middle Aged
Osteolysis / etiology*
Prosthesis Design
Prosthesis Failure*
Retrospective Studies
Reg. No./Substance:
0/Cross-Linking Reagents; 9002-88-4/Polyethylene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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