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Titolo:
Characterization of long-term femoral-head-penetration rates - Associationwith and prediction of osteolysis
Autore:
Dowd, JE; Sychterz, CJ; Young, AM; Engh, CA;
Indirizzi:
Anderson Orthopaed Res Inst, Alexandria, VA 22307 USA Anderson Orthopaed Res Inst Alexandria VA USA 22307 xandria, VA 22307 USA
Titolo Testata:
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
fascicolo: 8, volume: 82A, anno: 2000,
pagine: 1102 - 1107
SICI:
0021-9355(200008)82A:8<1102:COLFR->2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
WEAR;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Dowd, JE Orthopaed Associates Virginia, 6275 E Virginia Beach Blvd,Suite 300, Norfolk, VA 23502 USA Orthopaed Associates Virginia 6275 E Virginia Beach Blvd,Suite 300 Norfolk VA USA 23502
Citazione:
J.E. Dowd et al., "Characterization of long-term femoral-head-penetration rates - Associationwith and prediction of osteolysis", J BONE-AM V, 82A(8), 2000, pp. 1102-1107

Abstract

Background: We examined the relationship between long-term femoral-head-penetration patterns and osteolysis in a ten-year follow-up study of a well controlled patient population. The purposes of this study were to characterize the linearity of long-term head-penetration patterns over time, to describe the relationship between ten-year true wear rates and osteolysis, and to determine whether the occurrence of osteolysis at ten years could be predicted by penetration data obtained prior to five years. Methods: Temporal femoral-head-penetration patterns were examined at a minimum of ten years after forty-eight primary total hip arthroplasties. The arthroplasties were performed with the use of an Arthropor acetabular cup (Joint Medical Products) and a thirty-two-millimeter-diameter cobalt-chromiumfemoral head (DePuy), Using a computer-assisted radiographic technique, weevaluated two-dimensional head penetration on serial annual radiographs. Linear regression analysis modeled penetration-versus-time data as a line for each patient. The slope of the regression line indicated the true wear rate for each patient. In a subgroup of thirty-four hips for which three annual radiographs had been made less than five years after the arthroplasty, we compared early head-penetration patterns with the later occurrence of osteolysis. Results: For all forty-eight hips, the true wear rate averaged 0.18 millimeter per gear (range, 0.01 to 0.44 millimeter per year) and temporal head-penetration patterns tended to be linear (mean r(2) = 0.91 +/- 0.16). Osteolysis at ten years was strongly associated with increasing true wear rates (p < 0.001), Osteolysis did not develop in any of the nine hips with a true wear rate of less than 0.1 millimeter per year. However, osteolysis developed in nine (43 percent) of twenty-one hips,vith a rate between 0.1 and lessthan 0.2 millimeter per year, in eight of ten hips with a rate between 0.2and 0.3 millimeter per year, and in all eight hips with a rate of greater than 0.3 millimeter per year. Evaluation of early true wear rates as a predictor of late osteolysis showed a similar relationship. Conclusions: This study demonstrates that true wear rates tend to be constant and that increased true wear is significantly associated with osteolysis at ten years after the operation. A similar relationship was also found at the early follow-up interval, indicating that early true wear rates (determined from serial radiographs) might enable orthopaedists to predict if patients are at risk for the development of osteolysis. Clinical Relevance: On the basis of these findings, we use temporal femoral-head-penetration data in our practice to evaluate polyethylene inserts inasymptomatic patients, to estimate the time to component wear-through, andto adjust the frequency of follow-up evaluations for monitoring the development of osteolytic lesions in at-risk patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/07/20 alle ore 22:14:01