*Corresponding author:Lokesh Gudda Naik, Fellow in Arthroplasty and Revision Arthroplasty, Under Professor Won Yong Shon, Department of Arthroplasty, Korea university Guro Hospital, Seoul, South Korea, Clinical Associate, Department of Orthopaedics, Sir HN Reliance Foundation Hopsital, Mumbai, India
Received: February 14, 2018; Published: February 21, 2018
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Polyethylene wear in both cemented and uncemented total hip arthroplasty (THA) lead to generation of particles with their access to the interface which has been responsible for periprosthetic osteolysis and subsequent loosening of cup and stem. Many studies have been published studying the pattern of polyethylene wear and its relation to the type of implant (cemented/ uncemented cup or ceramic/metal head) used. No study in our knowledge has strictly focused on the effect of cemented versus uncemented stem on the polyethylene wear rates. We tried to compare the polyethylene wear rates reckoned with software (Poly Ware REV 7) of ultra high molecular weight polyethylene (UHMWPE) in hybrid and uncemented THA and its effect on complications of total hip replacements. We retrospectively reviewed pre-matched 56 patients in uncemented group with 112 patients in hybrid group on the basis of polyethylene wear rate, revision rates and clinical issues, with mean follow up of 9.42 and 7.25 years (yrs.) respectively.
Mean polyethylene wear rate in uncemented group was 0.048 milli metres per year (mm/yr.) and it was 0.082 mm/yr. in hybrid. Wear rate in hybrid group ceramic head (0.072mm/yr.) was significant when compared to wear rate ceramic head in uncemented group (0.053mm/yr.), also we found significant difference of poly wear in the metallic group as well. There was no difference in stem loosening and cup osteolysis in low wear (<.05 mm/yr.) and high wear group (>.05mm/yr.) in both uncemented and hybrid THA. The revision was significantly higher in uncemented group but when adjusted with the age, it is equivocal. We found significant difference in polyethylene wear rates, but no significant difference in clinical performance and revisions among the two groups of uncemented THA and hybrid THA when compared on a mid-term 8 to 10 yrs. Follow up.
Keywords: Total Hip Arthroplasty; Polywear; Uncemented THA; Hybrid THA
Abbreviations: THA: Total Hip Arthroplasty; UHMWPE: Ultra High Molecular Weight Poly Ethylene; Yrs: Years; Mm/yr: Millimetres per year; PACS: Picture Archiving and Communication System; HHS: Harris Hip Scores; LLD: Limb Length Discrepancy