Hip Pelvis.  2014 Dec;26(4):220-226. 10.5371/hp.2014.26.4.220.

Results of Primary Total Hip Arthroplasty with 36-mm Femoral Heads on Highly Cross-linked Polyethylene-Minimum Seven-years Follow-up

• Choi WK
• Cho MR
• Lee JH

• KMID: 1907697
• DOI: http://doi.org/10.5371/hp.2014.26.4.220

Abstract

PURPOSE
We evaluate the clinical and radiographic midterm results of primary total hip arthroplasty (THA) using a 36 mm diameter femoral head on highly cross-linked polyethylene (minimum 7-year follow-up).
MATERIALS AND METHODS
We retrospectively reviewed 73 patients (74 hips) that underwent primary THA with a 36 mm diameter femoral head on highly cross-linked polyethylene between July 2004 and February 2007. Clinical follow-ups included specific measurements like modified Harris hip scores (HHS) and Merle d'Aubigne and Postel score. For radiologic evaluations, together with position of acetabular cup at 6 weeks later of post-operation, we separately calculated the penentrations of femoral heads into polyethylene liners during post-operation and one year later check-ups, and during one year later check-ups and final check-ups.
RESULTS
There were no complications except for one case of dislocation. Average modified HHS at final follow-up was 88+/-7.5 (range, 81-96), and Merle d'Aubigne and Postel scores were more than 15 (range, 15-18). Mean acetabular cup inclination and anteversion were 50.1degrees(range, 35degrees-58degrees) and 23.6degrees(range, 5degrees-38degrees), respectively. Average femoral head penetration during the first postoperative year was 0.071+/-0.034 mm/year, and steady-state wear rate determined using radiographs taken at one-year postoperatively and at latest follow-up was 0.051+/-0.022 mm/year. Average femoral head penetration during entire follow-ups was 0.058+/-0.013 mm/year.
CONCLUSION
Primary THA with a large diameter femoral head on highly cross-linked polyethylene was found to produce the results comparable to previous in vitro laboratory hip simulation studies. And we also find out good scores in terms of patient's functionality.

Keyword

36-mm femoral head; Highly cross-linked polyethylene; Total hip arthroplasty; Minimum 7-years follow-up

MeSH Terms

Acetabulum
Arthroplasty, Replacement, Hip*
Dislocations
Follow-Up Studies*
Head*
Hip
Humans
Polyethylene
Retrospective Studies
Polyethylene

Figure

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  Fig. 1 Fifty-eight years man underwent with primary total hip replacement arthroplasty with 36 mm femoral head due to avascular necrosis of femoral head. Anteroposterior view of post-operation (A) and axial view (B).

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  Fig. 2 If we designate 3 points at outer-shape of head and cup, PolyWare Pro three-dimensional program make circle-line automatically. The program calculates the penetration rate with comparing between initial X-ray circle line (A) and follow-up X-ray circle-line (B).

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  Fig. 3 Radiograph images. (A) Anteroposterior (AP) radiograph of 31-year-old woman showed posterior dislocation with acetabular fracture. (B) Acetabular was reducted and fixed with recon-plate. (C) AP radiograph showed a total hip replacement arthroplasty state using 36-mm femoral head with highly cross-linked polyethylene. (D) Dislocation state.

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