N°011 - May / June 2021
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Different Bearing Options in THA – What hip surgeons should consider
By Antonino Giulio Battaglia, Rocco D’Apolito, Fabio Labionda, Luigi Zagra in category UPDATE
IRCCS Istituto Ortopedico Galeazzi, Hip Department, Milan Italy / [email protected]
Total hip arthroplasty (THA) is widely considered to be one of the most successful surgical procedures in orthopedics. It is associated with high satisfaction rates and significant improvement in quality of life following surgery [1,2]. According to recently published data from the British National Joint Registry, the cumulative survival of THA at 13 years is 93.2%, with 80% of implants surviving up to 20 years . However, according to the Australian National Joint Replacement Registry, failures are still recorded, and causes of revision of THA are, in order of frequency , loosening, fracture, dislocation, infection and osteolysis at more than 10 years of follow-up. Regarding aseptic loosening, osteolysis and material wear are the most common causes of revision for failures occurring at more than one year after the index procedure [5,6].
Several combinations of liners and heads are available, each one having advantages and disadvantages. Wear and osteolysis represent a concern for conventional PE bearings (with metal or ceramics heads). Particulate debris and resulting biologic response play a key role in osteolysis and loosening. PE particulate debris activate macrophages that release an array of cytokines and pro-inflammatory mediators in the joint fluid...
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