Long-term computed tomographic osteolytic analysis of highly cross-linked polyethylene prosthesis after total hip arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Xipeng ,  LIU Jiangtao

Department of Orthopaedic Surgery, the Central Hospital of Wuhan, Tongji Medical College of Huazhong University of Science & Technology, Wuhan Hubei, 430010, P. R. China;

Corresponding author：

LIU Jiangtao, Email: ljt73@sohu.com

Keywords：

Total hip arthroplasty; osteolysis; highly cross-linked polyethylene prosthesis; CT imaging

DOI：

10.7507/1002-1892.202403040

Video：

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Objective To analyze the occurrence of osteolysis in total hip arthroplasty (THA) with highly cross-linked polyethylene prosthesis during a follow-up of more than 15 years. Methods The clinical data of 84 patients (105 hips) treated with THA in the Affiliated Hospital of Kanazawa Medical University in Japan between June 2000 and April 2004 and met the selection criteria was retrospectively analyzed. There were 7 males and 77 females, aged from 41 to 75 years, with an average of 56.4 years. There were 94 hips with secondary hip osteoarthritis, 4 hips after pelvic osteotomy, 2 hips with primary hip osteoarthritis, 2 hips with traumatic hip osteoarthritis, 2 hips with osteonecrosis of the femoral head, and 1 hip with rheumatoid arthritis. According to Crowe classification, there were 79 hips of type Ⅰ, 19 hips of type Ⅱ, 6 hips of type Ⅲ, and 1 hip of type Ⅳ. The highly cross-linked polyethylene acetabular liner combined with a 26 mm zirconia femoral head were used in all patients. X-ray films were taken after operation to analyze the radiation transmission and osteolysis around the acetabular prosthesis. The vertical distance (the distance between the teardrop line at the lower edge of the pelvis and the perpendicular line of the hip rotation center), the horizontal distance (the horizontal distance between the hip rotation center and the interteardrop line and the vertical line at the lower edge of the teardrop), and the acetabular cup anteversion angle were measured at last follow-up. The acetabular and femoral osteolysis was analyzed by CT scan and three-dimensional multiplanar reconstruction (3D-MPR). Combined with X-ray film and CT results, osteolysis was evaluated according to the Narkbunnam score. Results Deep vein thrombosis of lower limbs occurred in 2 cases. All patients were followed up 15-18 years, with an average of 15.9 years. One hip dislocation and 1 periprosthetic fracture occurred postoperatively, and no acetabular loosening or prosthetic lining ruptures occurred. Except for 1 patient who had a radiolucent line in the acetabulum after operation, the other 83 patients did not show any radiolucent line in the acetabulum or the femur. None of the patients underwent hip revision. X-ray films at last follow-up showed an acetabular cup anteversion angle of −10°-39°, with an average of 22°; a vertical distance of 3.5-47.1 mm, with an average of 24.6 mm; and a horizontal distance of 22.6-48.1 mm, with an average of 31.7 mm. There was no acetabular or femoral osteolysis in all patients on X-ray films and CT 3D-MPR images at last follow-up, and the Narkbunnam score was 0 in any region. Conclusion Highly cross-linked polyethylene prosthesis does not increase the risk of long-term complications such as osteolysis after THA.

Citation： WANG Xipeng, LIU Jiangtao. Long-term computed tomographic osteolytic analysis of highly cross-linked polyethylene prosthesis after total hip arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(9): 1079-1085. doi: 10.7507/1002-1892.202403040 Copy

1.	Mall NA, Nunley RM, Zhu JJ, et al. The incidence of acetabular osteolysis in young patients with conventional versus highly crosslinked polyethylene. Clin Orthop Relat Res, 2011, 469(2): 372-381.
2.	Muratoglu OK, Bragdon CR, O’Connor DO, et al. A novel method of cross-linking ultra-high-molecular-weight polyethylene to improve wear, reduce oxidation, and retain mechanical properties. Recipient of the 1999 HAP Paul Award. J Arthroplasty, 2001, 16(2): 149-160.
3.	Harris WH. Conquest of a worldwide human disease: particle-induced periprosthetic osteolysis. Clin Orthop Relat Res, 2004, (429): 39-42.
4.	Kurtz SM, Gawel HA, Patel JD. History and systematic review of wear and osteolysis outcomes for first-generation highly crosslinked polyethylene. Clin Orthop Relat Res, 2011, 469(8): 2262-2277.
5.	袁杰, 尤佳, 万彦林, 等. 金属对金属髋关节假体置换术后的炎性假瘤. 中华骨科杂志, 2020, 40(3): 186-192.
6.	Muratoglu OK, Greenbaum ES, Bragdon CR, et al. Surface analysis of early retrieved acetabular polyethylene liners: a comparison of conventional and highly crosslinked polyethylenes. J Arthroplasty, 2004, 19(1): 68-77.
7.	Harris WH. Wear and periprosthetic osteolysis: the problem. Clin Orthop Relat Res, 2001, (393): 66-70.
8.	Jacobs CA, Christensen CP, Greenwald AS, et al. Clinical performance of highly cross-linked polyethylenes in total hip arthroplasty. J Bone Joint Surg (Am), 2007, 89(12): 2779-2786.
9.	Pedersen DR, Brown TD, Hillis SL, et al. Prediction of long-term polyethylene wear in total hip arthroplasty, based on early wear measurements made using digital image analysis. J Orthop Res, 1998, 16(5): 557-563.
10.	Griffifith MJ, Seidenstein MK, Williams D, et al. Socket wear in Charnley low friction arthroplasty of the hip. Clin Orthop Relat Res, 1978, (137): 37-47.
11.	Claus AM, Engh CA Jr, Sychterz CJ, et al. Radiographic definition of pelvic osteolysis following total hip arthroplasty. J Bone Joint Surg (Am), 2003, 85(8): 1519-1526.
12.	Stamenkov R, Howie D, Taylor J, et al. Measurement of bone defects adjacent to acetabular components of hip replacement. Clin Orthop Relat Res, 2003, (412): 117-124.
13.	Leung SB, Egawa H, Stepniewski A, et al. Incidence and volume of pelvic osteolysis at early follow-up with highly cross-linked and noncross-linked polyethylene. J Arthroplasty, 2007, 22(6 Suppl 2): 134-139.
14.	Walde TA, Weiland DE, Leung SB, et al. Comparison of CT, MRI, and radiographs in assessing pelvic osteolysis: a cadaveric study. Clin Orthop Relat Res, 2005(437): 138-144.
15.	de Steiger R, Lorimer M, Graves SE. Cross-linked polyethylene for total hip arthroplasty markedly reduces revision surgery at 16 years. J Bone Joint Surg (Am), 2018, 100(15): 1281-1288.
16.	Feng JE, Novikov D, Chen K, et al. Up to 18-year follow-up wear analysis of a first-generation highly cross-linked polyethylene in primary total hip arthroplasty. J Arthroplasty, 2018, 33(10): 3325-3328.
17.	Devane PA, Horne JG, Ashmore A, et al. Highly cross-linked polyethylene reduces wear and revision rates in total hip arthroplasty: A 10-year double-blinded randomized controlled trial. J Bone Joint Surg (Am), 2017, 99(20): 1703-1714.
18.	DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res, 1976(121): 20-32.
19.	Lachiewicz PF, O’Dell JA, Martell JM. Large metal heads and highly cross-linked polyethylene provide low wear and complications at 5-13 years. J Arthroplasty, 2018, 33(7): 2187-2191.
20.	Fukui K, Kaneuji A, Sugimori T, et al. A radiological study of the true anatomical position of the acetabulum in Japanese women. Hip Int, 2011, 21(3): 311-316.
21.	Narkbunnam R, Amanatullah DF, Electricwala AJ, et al. Radiographic scoring system for the evaluation of stability of cementless acetabular components in the presence of osteolysis. Bone Joint J, 2017, 99-B(5): 601-606.
22.	Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg (Am), 1969, 51(4): 737-755.
23.	Matsumoto T, Kaneuji A, Hiejima Y, et al. Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ): a patient-based evaluation tool for hip-joint disease. The Subcommittee on Hip Disease Evaluation of the Clinical Outcome Committee of the Japanese Orthopaedic Association. J Orthop Sci, 2012, 17(1): 25-38.
24.	Claus AM, Totterman SM, Sychterz CJ, et al. Computed tomography to assess pelvic lysis after total hip replacement. Clin Orthop Relat Res, 2004, (422): 167-174.
25.	Leung S, Naudie D, Kitamura N, et al. Computed tomography in the assessment of periacetabular osteolysis. J Bone Joint Surg (Am), 2005, 87(3): 592-597.
26.	Puri L, Wixson RL, Stern SH, et al. Use of helical computed tomography for the assessment of acetabular osteolysis after total hip arthroplasty. J Bone Joint Surg (Am), 2002, 84(4): 609-614.
27.	Maloney WJ, Galante JO, Anderson M, et al. Fixation, polyethylene wear, and pelvic osteolysis in primary total hip replacement. Clin Orthop Relat Res, 1999, (369): 157-164.
28.	Dumbleton JH, Manley MT, Edidin AA. A literature review of the association between wear rate and osteolysis in total hip arthroplasty. J Arthroplasty, 2002, 17(5): 649-661.
29.	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.
30.	Paulus AC, Frenzel J, Ficklscherer A, et al. Polyethylene wear particles induce TLR 2 upregulation in the synovial layer of mice. J Mater Sci Mater Med, 2014, 25(2): 507-513.
31.	Glyn-Jones S, Thomas GE, Garfjeld-Roberts P, et al. The John Charnley Award: Highly crosslinked polyethylene in total hip arthroplasty decreases long-term wear: a double-blind randomized trial. Clin Orthop Relat Res, 2015, 473(2): 432-438.
32.	Fukui K, Kaneuji A, Sugimori T, et al. Wear comparison between conventional and highly cross-linked polyethylene against a zirconia head: a concise follow-up, at an average 10 years, of a previous report. J Arthroplasty, 2013, 28(9): 1654-1658.
33.	Fukui K, Kaneuji A, Sugimori T, et al. Wear comparison between a highly cross-linked polyethylene and conventional polyethylene against a zirconia femoral head: minimum 5-year follow-up. J Arthroplasty, 2011, 26(1): 45-49.
34.	Thomas GE, Simpson DJ, Mehmood S, et al. The seven-year wear of highly cross-linked polyethylene in total hip arthroplasty: a double-blind, randomized controlled trial using radiostereometric analysis. J Bone Joint Surg (Am), 2011, 93(8): 716-722.
35.	Hopper RH, Ho H, Sritulanondha S, et al. Otto aufranc award: Crosslinking reduces THA wear, osteolysis, and revision rates at 15-year followup compared with noncrosslinked polyethylene. Clin Orthop Relat Res, 2018, 476(2): 279-290.
36.	Nebergall AK, Greene ME, Rubash H, et al. Thirteen-year evaluation of highly cross-linked polyethylene articulating with either 28-mm or 36-mm femoral heads using radiostereometric analysis and computerized tomography. J Arthroplasty, 2016, 31(9 Suppl): 269-276.
37.	Howie DW, Holubowycz OT, Callary SA. The wear rate of highly cross-linked polyethylene in total hip replacement is not increased by large articulations: A randomized controlled trial. J Bone Joint Surg (Am), 2016, 98(21): 1786-1793.
38.	Broomfield JA, Malak TT, Thomas GE, et al. The relationship between polyethylene wear and periprosthetic osteolysis in total hip arthroplasty at 12 years in a randomized controlled trial cohort. J Arthroplasty, 2017, 32(4): 1186-1191.
39.	Tsukamoto M, Ohnishi H, Mori T, et al. Fifteen-year comparison of wear and osteolysis analysis for cross-linked or conventional polyethylene in cementless total hip arthroplasty for hip dysplasia—A retrospective cohort study. J Arthroplasty, 2017, 32(1): 161-165.
40.	朱家庆, 孙家豪, 刘金柱, 等. 人工智能术前规划系统辅助人工全髋关节置换术后翻修手术的疗效研究. 中国修复重建外科杂志, 2024, 38(4): 455-460.
41.	Taniguchi N, Jinno T, Takada R, et al. Do screws and screw holes affect osteolysis in cementless cups using highly crosslinked polyethylene? A 7 to 10-year follow-up case-control study. Orthop Traumatol Surg Res, 2018, 104(3): 307-315.
42.	Gallen RA, Khan RJK, Haebich SJ, et al. Solid cup vs cluster hole in total hip arthroplasty: A 10-year randomized control trial. J Arthroplasty, 2018, 33(4): 1113-1119.
43.	Callaghan JJ, Salvati EA, Pellicci PM, et al. Results of revision for mechanical failure after cemented total hip replacement, 1979 to 1982. A two to five-year follow-up. J Bone Joint Surg (Am), 1985, 67(7): 1074-1085.
44.	Pagnano W, Hanssen AD, Lewallen DG, et al. The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg (Am), 1996, 78(7): 1004-1014.
45.	Galea VP, Laaksonen I, Donahue GS, et al. Developmental dysplasia treated with cementless total hip arthroplasty utilizing high hip center reconstruction: A minimum 13-year follow-up study. J Arthroplasty, 2018, 33(9): 2899-2905.
46.	Morrison TA, Moore RD, Meng J, et al. No difference in conventional polyethylene wear between yttria-stabilized zirconia and cobalt-chromium-molybdenum femoral heads at 10 years. HSS J, 2018, 14(1): 60-66.
47.	Fukui K, Kaneuji A, Sugimori T, et al. Retrieval analysis of new-generation yttria-stabilized zirconia femoral heads after total hip arthroplasty. Eur J Orthop Surg Traumatol, 2014, 24(7): 1197-1202.
48.	Cheung A, Yan CH, Fu H, et al. Ten- to sixteen-year follow-up of highly cross-linked polyethylene in total hip arthroplasty: What factors affect wear? J Arthroplasty, 2019, 34(9): 2016-2021.
49.	Haw JG, Battenberg AK, Huang DT, et al. Wear rates of larger-diameter cross-linked polyethylene at 5 to 13 years: Does liner thickness or component position matter? J Arthroplasty, 2017, 32(4): 1381-1386.

1. Mall NA, Nunley RM, Zhu JJ, et al. The incidence of acetabular osteolysis in young patients with conventional versus highly crosslinked polyethylene. Clin Orthop Relat Res, 2011, 469(2): 372-381.
2. Muratoglu OK, Bragdon CR, O’Connor DO, et al. A novel method of cross-linking ultra-high-molecular-weight polyethylene to improve wear, reduce oxidation, and retain mechanical properties. Recipient of the 1999 HAP Paul Award. J Arthroplasty, 2001, 16(2): 149-160.
3. Harris WH. Conquest of a worldwide human disease: particle-induced periprosthetic osteolysis. Clin Orthop Relat Res, 2004, (429): 39-42.
4. Kurtz SM, Gawel HA, Patel JD. History and systematic review of wear and osteolysis outcomes for first-generation highly crosslinked polyethylene. Clin Orthop Relat Res, 2011, 469(8): 2262-2277.
5. 袁杰, 尤佳, 万彦林, 等. 金属对金属髋关节假体置换术后的炎性假瘤. 中华骨科杂志, 2020, 40(3): 186-192.
6. Muratoglu OK, Greenbaum ES, Bragdon CR, et al. Surface analysis of early retrieved acetabular polyethylene liners: a comparison of conventional and highly crosslinked polyethylenes. J Arthroplasty, 2004, 19(1): 68-77.
7. Harris WH. Wear and periprosthetic osteolysis: the problem. Clin Orthop Relat Res, 2001, (393): 66-70.
8. Jacobs CA, Christensen CP, Greenwald AS, et al. Clinical performance of highly cross-linked polyethylenes in total hip arthroplasty. J Bone Joint Surg (Am), 2007, 89(12): 2779-2786.
9. Pedersen DR, Brown TD, Hillis SL, et al. Prediction of long-term polyethylene wear in total hip arthroplasty, based on early wear measurements made using digital image analysis. J Orthop Res, 1998, 16(5): 557-563.
10. Griffifith MJ, Seidenstein MK, Williams D, et al. Socket wear in Charnley low friction arthroplasty of the hip. Clin Orthop Relat Res, 1978, (137): 37-47.
11. Claus AM, Engh CA Jr, Sychterz CJ, et al. Radiographic definition of pelvic osteolysis following total hip arthroplasty. J Bone Joint Surg (Am), 2003, 85(8): 1519-1526.
12. Stamenkov R, Howie D, Taylor J, et al. Measurement of bone defects adjacent to acetabular components of hip replacement. Clin Orthop Relat Res, 2003, (412): 117-124.
13. Leung SB, Egawa H, Stepniewski A, et al. Incidence and volume of pelvic osteolysis at early follow-up with highly cross-linked and noncross-linked polyethylene. J Arthroplasty, 2007, 22(6 Suppl 2): 134-139.
14. Walde TA, Weiland DE, Leung SB, et al. Comparison of CT, MRI, and radiographs in assessing pelvic osteolysis: a cadaveric study. Clin Orthop Relat Res, 2005(437): 138-144.
15. de Steiger R, Lorimer M, Graves SE. Cross-linked polyethylene for total hip arthroplasty markedly reduces revision surgery at 16 years. J Bone Joint Surg (Am), 2018, 100(15): 1281-1288.
16. Feng JE, Novikov D, Chen K, et al. Up to 18-year follow-up wear analysis of a first-generation highly cross-linked polyethylene in primary total hip arthroplasty. J Arthroplasty, 2018, 33(10): 3325-3328.
17. Devane PA, Horne JG, Ashmore A, et al. Highly cross-linked polyethylene reduces wear and revision rates in total hip arthroplasty: A 10-year double-blinded randomized controlled trial. J Bone Joint Surg (Am), 2017, 99(20): 1703-1714.
18. DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res, 1976(121): 20-32.
19. Lachiewicz PF, O’Dell JA, Martell JM. Large metal heads and highly cross-linked polyethylene provide low wear and complications at 5-13 years. J Arthroplasty, 2018, 33(7): 2187-2191.
20. Fukui K, Kaneuji A, Sugimori T, et al. A radiological study of the true anatomical position of the acetabulum in Japanese women. Hip Int, 2011, 21(3): 311-316.
21. Narkbunnam R, Amanatullah DF, Electricwala AJ, et al. Radiographic scoring system for the evaluation of stability of cementless acetabular components in the presence of osteolysis. Bone Joint J, 2017, 99-B(5): 601-606.
22. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg (Am), 1969, 51(4): 737-755.
23. Matsumoto T, Kaneuji A, Hiejima Y, et al. Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ): a patient-based evaluation tool for hip-joint disease. The Subcommittee on Hip Disease Evaluation of the Clinical Outcome Committee of the Japanese Orthopaedic Association. J Orthop Sci, 2012, 17(1): 25-38.
24. Claus AM, Totterman SM, Sychterz CJ, et al. Computed tomography to assess pelvic lysis after total hip replacement. Clin Orthop Relat Res, 2004, (422): 167-174.
25. Leung S, Naudie D, Kitamura N, et al. Computed tomography in the assessment of periacetabular osteolysis. J Bone Joint Surg (Am), 2005, 87(3): 592-597.
26. Puri L, Wixson RL, Stern SH, et al. Use of helical computed tomography for the assessment of acetabular osteolysis after total hip arthroplasty. J Bone Joint Surg (Am), 2002, 84(4): 609-614.
27. Maloney WJ, Galante JO, Anderson M, et al. Fixation, polyethylene wear, and pelvic osteolysis in primary total hip replacement. Clin Orthop Relat Res, 1999, (369): 157-164.
28. Dumbleton JH, Manley MT, Edidin AA. A literature review of the association between wear rate and osteolysis in total hip arthroplasty. J Arthroplasty, 2002, 17(5): 649-661.
29. 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.
30. Paulus AC, Frenzel J, Ficklscherer A, et al. Polyethylene wear particles induce TLR 2 upregulation in the synovial layer of mice. J Mater Sci Mater Med, 2014, 25(2): 507-513.
31. Glyn-Jones S, Thomas GE, Garfjeld-Roberts P, et al. The John Charnley Award: Highly crosslinked polyethylene in total hip arthroplasty decreases long-term wear: a double-blind randomized trial. Clin Orthop Relat Res, 2015, 473(2): 432-438.
32. Fukui K, Kaneuji A, Sugimori T, et al. Wear comparison between conventional and highly cross-linked polyethylene against a zirconia head: a concise follow-up, at an average 10 years, of a previous report. J Arthroplasty, 2013, 28(9): 1654-1658.
33. Fukui K, Kaneuji A, Sugimori T, et al. Wear comparison between a highly cross-linked polyethylene and conventional polyethylene against a zirconia femoral head: minimum 5-year follow-up. J Arthroplasty, 2011, 26(1): 45-49.
34. Thomas GE, Simpson DJ, Mehmood S, et al. The seven-year wear of highly cross-linked polyethylene in total hip arthroplasty: a double-blind, randomized controlled trial using radiostereometric analysis. J Bone Joint Surg (Am), 2011, 93(8): 716-722.
35. Hopper RH, Ho H, Sritulanondha S, et al. Otto aufranc award: Crosslinking reduces THA wear, osteolysis, and revision rates at 15-year followup compared with noncrosslinked polyethylene. Clin Orthop Relat Res, 2018, 476(2): 279-290.
36. Nebergall AK, Greene ME, Rubash H, et al. Thirteen-year evaluation of highly cross-linked polyethylene articulating with either 28-mm or 36-mm femoral heads using radiostereometric analysis and computerized tomography. J Arthroplasty, 2016, 31(9 Suppl): 269-276.
37. Howie DW, Holubowycz OT, Callary SA. The wear rate of highly cross-linked polyethylene in total hip replacement is not increased by large articulations: A randomized controlled trial. J Bone Joint Surg (Am), 2016, 98(21): 1786-1793.
38. Broomfield JA, Malak TT, Thomas GE, et al. The relationship between polyethylene wear and periprosthetic osteolysis in total hip arthroplasty at 12 years in a randomized controlled trial cohort. J Arthroplasty, 2017, 32(4): 1186-1191.
39. Tsukamoto M, Ohnishi H, Mori T, et al. Fifteen-year comparison of wear and osteolysis analysis for cross-linked or conventional polyethylene in cementless total hip arthroplasty for hip dysplasia—A retrospective cohort study. J Arthroplasty, 2017, 32(1): 161-165.
40. 朱家庆, 孙家豪, 刘金柱, 等. 人工智能术前规划系统辅助人工全髋关节置换术后翻修手术的疗效研究. 中国修复重建外科杂志, 2024, 38(4): 455-460.
41. Taniguchi N, Jinno T, Takada R, et al. Do screws and screw holes affect osteolysis in cementless cups using highly crosslinked polyethylene? A 7 to 10-year follow-up case-control study. Orthop Traumatol Surg Res, 2018, 104(3): 307-315.
42. Gallen RA, Khan RJK, Haebich SJ, et al. Solid cup vs cluster hole in total hip arthroplasty: A 10-year randomized control trial. J Arthroplasty, 2018, 33(4): 1113-1119.
43. Callaghan JJ, Salvati EA, Pellicci PM, et al. Results of revision for mechanical failure after cemented total hip replacement, 1979 to 1982. A two to five-year follow-up. J Bone Joint Surg (Am), 1985, 67(7): 1074-1085.
44. Pagnano W, Hanssen AD, Lewallen DG, et al. The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg (Am), 1996, 78(7): 1004-1014.
45. Galea VP, Laaksonen I, Donahue GS, et al. Developmental dysplasia treated with cementless total hip arthroplasty utilizing high hip center reconstruction: A minimum 13-year follow-up study. J Arthroplasty, 2018, 33(9): 2899-2905.
46. Morrison TA, Moore RD, Meng J, et al. No difference in conventional polyethylene wear between yttria-stabilized zirconia and cobalt-chromium-molybdenum femoral heads at 10 years. HSS J, 2018, 14(1): 60-66.
47. Fukui K, Kaneuji A, Sugimori T, et al. Retrieval analysis of new-generation yttria-stabilized zirconia femoral heads after total hip arthroplasty. Eur J Orthop Surg Traumatol, 2014, 24(7): 1197-1202.
48. Cheung A, Yan CH, Fu H, et al. Ten- to sixteen-year follow-up of highly cross-linked polyethylene in total hip arthroplasty: What factors affect wear? J Arthroplasty, 2019, 34(9): 2016-2021.
49. Haw JG, Battenberg AK, Huang DT, et al. Wear rates of larger-diameter cross-linked polyethylene at 5 to 13 years: Does liner thickness or component position matter? J Arthroplasty, 2017, 32(4): 1381-1386.

Chinese Journal of Reparative and Reconstructive Surgery

Long-term computed tomographic osteolytic analysis of highly cross-linked polyethylene prosthesis after total hip arthroplasty

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