Background and purpose - Most registry studies regarding highly crosslinked polyethylene (XLPE) have focused on the overall revision risk. We compared the risk of cup and/or liner revision for specific cup and liner designs made of either XLPE or conventional polyethylene (CPE), regarding revision for any reason and revision due to aseptic loosening and/or osteolysis. Patients and methods - Using the Nordic Arthroplasty Register Association (NARA) database, we identified cup and liner designs where either XLPE or CPE had been used in more than 500 THAs performed for primary hip osteoarthritis. We assessed risk of revision for any reason and for aseptic loosening using Cox regression adjusted for age, sex, femoral head material and size, surgical approach, stem fixation, and presence of hydroxyapatite coating (uncemented cups). Results - The CPE version of the ZCA cup had a risk of revision for any reason similar to that of the XLPE version (p = 0.09), but showed a 6-fold higher risk of revision for aseptic loosening (p < 0.001). The CPE version of the Reflection All Poly cup had an 8-fold elevated risk of revision for any reason (p < 0.001) and a 5-fold increased risk of revision for aseptic loosening (p < 0.001). The Charnley Elite Ogee/Marathon cup and the Trilogy cup did not show such differences. Interpretation - Whether XLPE has any advantage over CPE regarding revision risk may depend on the properties of the polyethylene materials being compared, as well as the respective cup designs, fixation type, and follow-up times. Further research is needed to elucidate how cup design factors interact with polyethylene type to affect the risk of revision.

译文

:背景和目的-大多数有关高度交联聚乙烯(XLPE)的注册研究都集中在总体修订风险上。我们比较了由XLPE或常规聚乙烯(CPE)制成的特定杯和内胆设计的杯和/或内胆翻新风险,无论是出于任何原因的翻新还是由于无菌松动和/或溶骨引起的翻新。患者和方法-使用北欧人工关节置换协会(NARA)数据库,我们确定了杯状和衬垫设计,其中XLPE或CPE在用于原发性髋骨关节炎的500多例THA中已经使用。我们使用因年龄,性别,股骨头材料和大小,手术方法,茎固定和羟基磷灰石涂层(无胶量杯)调整的Cox回归评估了由于任何原因和无菌性松动的翻修风险。结果-ZCA杯的CPE版本由于与XLPE版本类似的任何原因而具有翻修的风险(p = 0.09),但显示出无菌松动翻修的风险高6倍(p <0.001)。 CPE版本的Reflection All Poly杯由于任何原因翻新风险增加了8倍(p <0.001),而无菌松动翻新风险增加了5倍(p <0.001)。 Charnley Elite Ogee / Marathon杯和Trilogy杯未显示出此类差异。解释-XLPE在翻新风险方面是否比CPE有任何优势可能取决于所比较的聚乙烯材料的特性,以及相应的杯设计,固定类型和随访时间。需要进一步研究来阐明杯形设计因素如何与聚乙烯类型相互作用以影响翻新的风险。

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