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General Orthopaedics

PERFORMANCE OF A FIRST GENERATION HIGHLY CROSS-LINKED POLYETHYLENE IN YOUNG (LESS THAN 55 YEARS) AND ACTIVE PATIENTS

The International Society for Technology in Arthroplasty (ISTA), 27th Annual Congress. PART 3.



Abstract

Background

Highly cross-linked polyethylene (HCLPE) was introduced to reduce wear and osteolysis in total hip arthroplasty (THA). There is no reported data regarding wear rates and clinical performance of Crossfire HCLPE (Stryker, Mahwah, New Jersey) in young and active patients. The purpose of this prospective study is to assess minimum 10-year wear rates and survivorship of Crossfire in young and active patients.

Material and Methods

Between January 2001 to December 2003, 52 consecutive THAs (43 patients; 26 males and 17 females), 55 years and younger, with an average University of California Los Angeles activity (UCLA) score of 7.3 ± 1.5 (5 – 10) at the time of surgery were prospectively followed. The mean age of patients was 47.4 ± 7.8 years old (range 24 to 55 years). Indication for surgery included osteoarthritis in all cases. All operations were performed by the senior surgeon via a posterolateral approach. All components were non-cemented SecurFit femoral stem, 28 mm Cobalt-Chromium (Co-Cr) femoral head, and Trident PSL cup with Crossfire HCLPE acetabular liner (Stryker, Mahwah, New Jersey). At minimum 10-years follow-up (mean 11.5 ± 0.94 years), wear rates were assessed using the Roman software. Hospital for Special Surgery (HSS) scores and survivorship data were analyzed.

Results

Good to excellent clinical results were seen with HSS score of 38.1 ± 4.7. The mean linear wear was 0.019 ± 0.018 mm/year (range 0 to 0.082). There were no revisions for osteolysis or loosening, periprosthetic infection or dislocation in this cohort. Kaplan-Meier survivorship was 100% for all failures.

Conclusion

This is the first study to demonstrate that metal on Crossfire performs very well with excellent survivorship and wear rates at a minimum 10-year follow-up in young and active patients. Oxidation concern with Crossfire has not caused any clinical problems up to 10 years.


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