Acetabular liner wear of cross-linked versus conventional polyethylene for total hip arthroplasty: a meta-analysis

doi:10.3969/j.issn.2095-4344.2017.07.028

Abstract

Abstract:

BACKGROUND: Aseptic loosening occurs after long-term total hip replacement, which directly affects the service life and prospective efficacy of artificial joints. The particles produced by artificial joint wear lead to the surrounding bone dissolved, further cause loosening, among which, polyethylene particles because of acetabular liner wear stand out.

OBJECTIVE: To systematically assess the acetabular liner wear, loosening and osteolysis caused by cross-linked polyethylene or conventional polyethylene after total hip arthroplasty.

METHODS: A computer-based research of Medline, EMbase, CBM, CNKI, CqVip, WanFang databases before December 2015 and Cochrane (3^rd issue, 2011) was performed in accordance with the retrieval strategy made by Cochrane collaboration. A manual retrieval of related bone journals and conference papers was conducted. Eleven randomized controlled trials about the wear caused by cross-linked polyethylene or conventional polyethylene after total hip arthroplasty were enrolled based on inclusion criteria, followed by a Meta-analysis using RevMan 5.0 software.

RESULTS AND CONCLUSION: (1) Eleven randomized controlled trials involving 952 patients were included. (2) Meta-analysis showed that the acetabular liner wear rate of cross-linked polyethylene was significantly lower than that of conventional polyethylene at 5 years postoperatively [MD=-0.07, CI(-0.09, -0.05), I²=93%, P < 0.000 01]; the large heterogeneity was decreased [MD=-0.06, 95%CI (-0.07, -0.04), I²=39%, P < 0.000 01] after three research removed through sensitivity analysis. (3) The osteolysis rate in the cross-linked polyethylene group was significantly lower than that in the conventional polyethylene group [RR=0.39, 95%CI (0.27, 0.57), I²=0%, P < 0.000 01]. (4) These results suggest that the cross-linked polyethylene liners exhibit reduced radiological wear and osteolysis, but the mean follow-up of 5 years (1.8 to 8.0) cannot meet the long-term requirements. Therefore, multi-central, large sample size and high-quality randomized controlled trials are needed to testify the efficacy and safety of cross-linked polyethylene.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Hip, Prosthesis Implantation, Meta-Analysis, Tissue Engineering

CLC Number:

R318

Ye Xiang-yang, Sun Xiang, Tang Li-xin, Zhen Ping, Geng Bin, Wang Hua-lei, Zhao Yu-guo. Acetabular liner wear of cross-linked versus conventional polyethylene for total hip arthroplasty: a meta-analysis [J]. Chinese Journal of Tissue Engineering Research, 2017, 21(7): 1143-1148.

Figures/Tables 3

References

[1] 邢金锋, 宋科官, 彭锂,等. 全关节成形术中假体周围骨溶解的概述:本体因素与未来发展方向[J]. 现代生物医学进展, 2016, 16(2): 386-389+316.

[2] 蒋营军, 吴连国. 人工关节置换术后磨损颗粒与假体周围骨溶解的研究进展[J]. 中国骨伤, 2016,30(10): 968-972.

[3] 杨兴, 薛峰, 盛晓文,等. 金属对聚乙烯假体全髋关节置换术后磨损的中期随访研究[J]. 岭南现代临床外科, 2015,15(1): 87-90.

[4] 陈锐, 戴闽. 关节置换术后假体周围骨溶解相关病理研究[J]. 国际骨科学杂志, 2009,46(6): 379-381.

[5] 许可, 马信龙, 李稚君,等. 全髋关节置换术应用高交联和传统聚乙烯内衬的Meta分析[J]. 中华创伤杂志, 2013,29(12): 1163-1169.

[6] 王萍, 谢蟪旭, 张绮,等. 如何在Cochrane系统评价中设计资料提取表[J]. 中国循证医学杂志, 2011,11(3): 341-345.

[7] 贾文琴,杨克虎,田金徽,等.cochrane系统评价发表状况调查[J].中国循证医学杂志,2009,9(6):635-639.

[8] 李静, 李幼平. 不断完善与发展的Cochrane系统评价[J]. 中国循证医学杂志, 2008,8(9): 742-743.

[9] 李静, 秦莉, 刘鸣. 系统评价的基本方法[J]. 中国循证医学, 2001,1(1): 34-38.

[10] 管红珍, 彭智聪, 傅鹰. 循证医学中文献证据等级标准的系统性综述[J]. 药物流行病学杂志, 2002,11(3):145-148+169.

[11] 吴泰相, 刘关键, 李静. 影响系统评价质量的主要因素浅析[J].中国循证医学杂志, 2005,5(1): 51-58.

[12] 张俊华, 商洪才, 张伯礼. 系统评价和meta分析质量的评价方法[J].中西医结合学报, 2008,6(4): 337-340.

[13] 钟晓蓉, 罗斌. Cochrane系统评价用户文摘(4)[J]. 华西医学, 2003,18(2):152-154.

[14] 谷鸿秋, 王杨, 李卫. Cochrane偏倚风险评估工具在随机对照研究Meta分析中的应用[J]. 中国循环杂志, 2014,29(2):147-148.

[15] 卫茂玲.cochrane系统评价在中国的现状与问题[J].中国循证医学杂志,2006,6(2):150-151.

[16] 孙晓莹, 马婧, 赵晔,等. Cochrane系统评价现状[J]. 中国循证儿科杂志, 2013,8(3): 237-240.

[17] 刘建平. 非随机研究的系统评价方法(一)[J]. 中国循证医学, 2001,1(4): 239-243.

[18] 屈会起, 张金钟, 邱明才. 循证医学的系统评价方法[J]. 中华医院管理杂志, 2000,16(6): 13-15.

[19] Calvert GT, Devane PA, Fielden J, et al. A double-blind, prospective, randomized controlled trial comparing highly cross-linked and conventional polyethylene in primary total hip arthroplasty. J Arthroplasty. 2009;24(4): 505-510.

[20] Engh CA Jr, Stepniewski AS, Ginn SD, et al. A randomized prospective evaluation of outcomes after total hip arthroplasty using cross-linked marathon and non-cross-linked Enduron polyethylene liners. J Arthroplasty. 2006;21(6 Suppl 2): 17-25.

[21] Garcia-Rey E, Garcia-Cimbrelo E, Cruz-Pardos A, et al. New polyethylenes in total hip replacement: a prospective, comparative clinical study of two types of liner. J Bone Joint Surg Br. 2008;90(2): 149-153.

[22] Geerdink CH, Grimm B, Ramakrishnan R, et al. Crosslinked polyethylene compared to conventional polyethylene in total hip replacement: pre-clinical evaluation, in-vitro testing and prospective clinical follow-up study. Acta Orthop. 2006;77(5): 719-725.

[23] Geerdink CH, Grimm B, Vencken W, et al. Cross-linked compared with historical polyethylene in THA: an 8-year clinical study. Clin Orthop Relat Res. 2009;467(4): 979-984.

[24] Ise K, Kawanabe K, Tamura J, et al. Clinical results of the wear performance of cross-linked polyethylene in total hip arthroplasty: prospective randomized trial. J Arthroplasty. 2009;24(8): 1216-1220.

[25] Martell JM, Verner JJ, Incavo SJ. Clinical performance of a highly cross-linked polyethylene at two years in total hip arthroplasty: a randomized prospective trial. J Arthroplasty. 2003;18(7 Suppl 1): 55-59.

[26] McCalden RW, MacDonald SJ, Rorabeck CH, et al. Wear rate of highly cross-linked polyethylene in total hip arthroplasty. A randomized controlled trial. J Bone Joint Surg Am. 2009;91(4): 773-782.

[27] Olyslaegers C, Defoort K, Simon JP, et al. Wear in conventional and highly cross-linked polyethylene cups: a 5-year follow-up study. J Arthroplasty. 2008;23(4): 489-494.

[28] Triclot P, Grosjean G, El Masri F, et al. A comparison of the penetration rate of two polyethylene acetabular liners of different levels of cross-linking. A prospective randomised trial. J Bone Joint Surg Br. 2007;89(11): 1439-1445.

[29] Glyn-Jones S, McLardy-Smith P, Gill HS, et al. The creep and wear of highly cross-linked polyethylene: a three-year randomised, controlled trial using radiostereometric analysis. J Bone Joint Surg Br. 2008;90(5): 556-561.

[30] 胡通洲, 童培建, 肖鲁伟. 全髋关节置换后聚乙烯磨损[J]. 国际骨科学杂志, 2008,29(1): 49-51.

[31] 梁材. 人工股骨头置换术后髋臼磨损的影响因素[J]. 临床医药实践, 2014,23(8): 605-608.

[32] Dorr LD, Wan Z, Shahrdar C, et al. Clinical performance of a Durasul highly cross-linked polyethylene acetabular liner for total hip arthroplasty at five years. J Bone Joint Surg Am. 2005;87(8): 1816-1821.

[33] Rajadhyaksha AD, Brotea C, Cheung Y, et al. Five-year comparative study of highly cross-linked (crossfire) and traditional polyethylene. J Arthroplasty. 2009;24(2): 161-167.

[34] Ingram JH, Stone M, Fisher J, et al. The influence of molecular weight, crosslinking and counterface roughness on TNF-alpha production by macrophages in response to ultra high molecular weight polyethylene particles. Biomaterials. 2004;25(17): 3511-3522.

[35] Yan Y, Chen H, Feng J, et al. Poor performance of Enduron polyethylene liner in total hip arthroplasty: a minimum ten-year follow up and ultra-morphological analysis of wear particles. Int Orthop. 2016. [Epub ahead of print]

[36] Bradford L, Baker D, Ries MD, et al. Fatigue crack propagation resistance of highly crosslinked polyethylene. Clin Orthop Relat Res. 2004;(429): 68-72.

[37] Bradford L, Baker DA, Graham J, et al. Wear and surface cracking in early retrieved highly cross-linked polyethylene acetabular liners. J Bone Joint Surg Am. 2004;86-A(6): 1271-1282.

[38] Muratoglu OK, Wannomae K, Christensen S, et al. Ex vivo wear of conventional and cross-linked polyethylene acetabular liners. Clin Orthop Relat Res. 2005;438: 158-164.

[39] 张国强, 王岩, 陈继营,等. 陶瓷对聚乙烯和金属对聚乙烯在全髋关节置换术后磨损的随访研究[J]. 中华关节外科杂志(电子版), 2010,4(3): 305-309.