title: Large diameter femoral heads on highly cross-linked polyethylene: minimum 3-year results.
abstract: Contemporary highly cross-linked polyethylenes have become the most widely used alternative bearing surfaces in total hip replacement and may be paired with large diameter femoral heads (> 32 mm) in patients considered to be at high risk for dislocation. We report on a prospective series of 42 patients (45 hips) who had total hip replacement using large diameter cobalt-chrome femoral heads articulating with a highly cross linked polyethylene after a minimum of 3 years followup (mean 3.3 years). At final followup, the final patient cohort showed excellent clinical results with no radiographic failures or episodes of loosening. There was no evidence of pelvic or femoral osteolysis. One patient sustained a dislocation due to a grossly malpositioned acetabular component necessitating early isolated acetabular revision. The average yearly steady state wear rate was -0.06 +/- 0.41 mm/year. The results of our short-term prospective series indicated total hip replacement with large femoral heads articulating with a highly cross linked polyethylene showed excellent wear characteristics and clinical results and could be considered in patients at increased risk for dislocation.
authors.affiliation: Columbia-Presbyterian Department of Orthopedic Surgery, USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Geller
authors.forename: Henrik
authors.initials: H
authors.lastname: Malchau
authors.forename: Charles
authors.initials: C
authors.lastname: Bragdon
authors.forename: Meridith
authors.initials: M
authors.lastname: Greene
authors.forename: William H
authors.initials: WH
authors.lastname: Harris
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Freiberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000517:prevention & control*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D020959:Polyethylene / Q000737:chemistry*; D011446:Prospective Studies; D011474:Prosthesis Design; D017755:Prosthesis Fitting / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D020959:Polyethylene