The ethylene oxide sterilised Opera acetabular component demonstrates high rates of loosening and revision compared to the gamma irradiated Ogee cup: a cohort study demonstrating potential shortcomings of revision-based registry data

2021 ◽  
pp. 112070002110189
Author(s):  
Kwaku W Baryeh ◽  
Kate Bennett ◽  
David H Sochart
Keyword(s):  
Ethylene Oxide ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Long Term Follow Up ◽  
Gamma Irradiated ◽  
Acetabular Implant ◽  
Acetabular Components ◽  
Ultra High Molecular Weight

Aims: To evaluate the long-term clinical outcomes of 2 cemented ultra-high molecular weight polyethylene (UHMWPE) acetabular components, with the main difference between the 2 components being their method of sterilisation. Patients and methods: Data was collected prospectively on 352 consecutive total hip replacements, performed between March 2000 and July 2004, at a single centre. A posterior approach was used with a cemented C-Stem femoral component (DePuy, Warsaw, IN, USA) in all cases and either the Ogee (DePuy, Warsaw, IN, USA) or the Opera (Smith & Nephew, Memphis, TN, USA) acetabular implant. Patients were reviewed clinically and radiologically with a median 12-year follow-up (6–16 years). Results: The risk of experiencing loosening was 90% lower for the Gamma irradiated implant (GII) group compared to the ethylene oxide sterilised implant (EOSI) group, which was statistically significant ( p = 0.003), (HR 0.10; 95% CI, 0.02–0.45). The incidence of cup revision was also lower in the GII group ( p = 0.029), but after adjustment for age, gender and BMI was not statistically significant ( p = 0.104). 15-year survivorship with failure/loosening as an endpoint was 70.1% for the EOS implant and 92.9% for the GII (OR 4.99; CI 95%, 1.75–14.2) and with revision as an endpoint was 81.4% for the EOSI and 92.9% for the GII (OR 2.60; CI 95%, 0.87–7.75) Conclusions: We report increased rates of loosening, revision and failure for the EOSI compared to the GII at long-term follow-up. This may have been attributable to the different sterilisation methods used.

scholarly journals A Long-term Follow-up study of Cemented Total Hip Replacements.

1992 ◽  
Vol 41 (2) ◽  
pp. 622-626
Author(s):  
Hisashi Yamashita ◽  
Fujio Higuchi ◽  
Akio Inoue
Keyword(s):  
Total Hip ◽  
Follow Up Study ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Long Term Follow Up

Intermediate to Long-Term Follow-up of Cementing Liners into Well-Fixed Acetabular Components

2020 ◽  
Vol 102 (16) ◽  
pp. 1397-1404 ◽  
Author(s):  
Nicholas A. Bedard ◽  
Matthew W. Tetreault ◽  
Arlen D. Hanssen ◽  
David G. Lewallen ◽  
Robert T. Trousdale ◽  
...  
Keyword(s):  
Long Term Follow Up ◽  
Acetabular Components

Alternative Bearing Couples in Total Hip Replacements: Solutions for Young Patients

2003 ◽  
Vol 13 (2_suppl) ◽  
pp. 31-35 ◽  
Author(s):  
J. Fisher ◽  
E. Ingham ◽  
M.H. Stone
Keyword(s):  
Polyethylene Wear ◽  
Young Patients ◽  
Volumetric Wear ◽  
Wear Rates ◽  
Total Hip Replacements ◽  
Metal On Metal ◽  
Hip Replacements ◽  
Gamma Irradiated ◽  
Ceramic On Ceramic

There is now considerable clinical concern about the effect of polyethylene wear debris induced osteolysis in long term failure of hip replacements. This paper compares the wear of stabilised and crosslinked polyethylene to alternative hard on hard bearings. The volumetric wear rates of stabilised and moderately crosslinked polyethylene 50 to 35 mm3/million cycles were less than previously reported for historical gamma irradiated in air polyethylene, but still of a level that in the long term could cause osteolysis. The moderately crosslinked polyethylene produced less wear than non-crosslinked polyethylene, but particles were smaller and more reactive resulting in little change in the osteolytic potential. Alumina ceramic on ceramic produced substantially less wear and osteolytic potential. Metal on metal also produced less wear than polyethylene but the particles adversely influence cell viability.

Correlation between Radiologic and Clinical Findings in Charnley Total Hip Replacement

1987 ◽  
Vol 28 (5) ◽  
pp. 607-613 ◽  
Author(s):  
B. Wejkner ◽  
M. Wiege
Keyword(s):  
Sagittal Plane ◽  
Femoral Stem ◽  
Clinical Findings ◽  
Total Hip ◽  
Radiologic Findings ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
The Relationship ◽  
Acetabular Components

The main purpose of this study was to evaluate the relationship between the radiologic findings in clinically successful Charnley total hip replacements (THR) at an average of five years postoperatively (‘5-year follow-up’) and the clinical result 10 to 14 years after operation (‘10-year follow-up’). The study included 150 arthroplasties graded as clinically successful at the 5-year follow-up despite radiologic loosening of the femoral component in 41 per cent and of the acetabular component in 7 per cent. The incidence of clinical failure between the two follow-ups was 7 per cent (10 hips). Only 2 per cent (3/125) of THRs with intact components or a loose stem with migration not exceeding 4 mm became failures. Clinical failures resulted in 28 per cent (7/25) of THRs with more extensive loosening of the stem or with a loose socket. At the 10-year follow-up 47 per cent of the femoral and 13 per cent of the acetabular components were loose. Progression of loosening of the femoral stem occurred in 63 per cent and of the socket in 73 per cent between the two follow-ups. The incidence of loosening of the stem showed a significant correlation both with the extent of cementation distal to the tip and with the orientation of the prosthesis in the sagittal plane.

Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis
Keyword(s):  
Mental Health ◽  
Mental Disease ◽  
Brain Disorders ◽  
Social Stressors ◽  
Labor Education ◽  
Mental Diseases ◽  
Long Term Follow Up ◽  
Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

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