Poor performance of Enduron polyethylene liner in total hip arthroplasty: a minimum ten-year follow up and ultra-morphological analysis of wear particles

2区 · 医学

Article

作者: Hong, Weixiang ; Chen, Hao ; Zhang, Jiong ; Wang, Yi ; Chen, Kaizhe ; Yan, Yufei ; He, Chuan ; Liu, Zhihong ; Yang, Qingming ; Zhou, Kaidi ; Guo, Lei ; Feng, Jianmin

PURPOSEThe aim of the present study was to investigate the long-term outcome and the wear characteristics of two distinct types of ultra-high molecular weight polyethylene (UHMWPE) liners in total hip arthroplasty (THA).METHODSWe conducted a retrospective clinical study on patients which were treated with total hip arthroplasty using either Enduron polyethylene (Enduron PE) or Trilogy polyethylene (Trilogy PE) liners based on a minimum of ten year follow up data. Morphological analyses of wear particles from tissue samples, which were harvested during revision surgeries, were also performed.RESULTSA total of 79 THAs in the Enduron group and 55 THAs in the Trilogy group were available for analysis. Kaplan-Meier survival with revision for wear-related complications as the endpoint of the Enduron PE liners was lower than that of Trilogy PE liners at ten years (93.5 % and 100 %, P = 0.03). The Enduron group had higher mean linear wear rate than that of the Trilogy group (0.20 ± 0.09 and 0.09 ± 0.03 mm/year, P < 0.01). The incidence of osteolysis for the Enduron group was higher than that of the Trilogy group (33.3 % and 12 %, P = 0.04). Under transmission electron microscopy, the Enduron group had more than 82 % of the particles less than 1.0 μm in size and more than 57 % of the particles less than 0.5 μm.CONCLUSIONThe long-term performance of Enduron liners was worse than that of Trilogy liners. Further clinical follow-up may be necessary in patients with Enduron PE liners in order to avoid catastrophic complications.

2012-01-01·Yao xue xue bao = Acta pharmaceutica Sinica

[Enantioselective determinination of R-warfarin/S-warfarin in human plasma using liquid chromatography-tandem mass spectrometry and its application in a drug-drug interaction study].

Article

作者: Jin, Shu ; Zhong, Da-Fang ; Liu, Ke ; Zhang, Yi-Fan ; Chen, Xiao-Yan

To study the drug-drug interaction of morinidazole and warfarin and its application, a sensitive and rapid liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was developed for the determination of R-warfarin/S-warfarin in human plasma. In a random, two-period crossover study, 12 healthy volunteers received a single oral dose of 5 mg racemic warfarin in the absence and presence of morinidazole. Blood samples were collected according to a pre-designed time schedule. R-warfarin, S-warfarin and methyclothiazide were extracted with ethylether : methylenechloride (3 : 2), then separated on a Astec Chirobiotic V (150 mm x 4.6 mm ID, 5 microm) column using 5 mmol x L(-1) ammonium acetate (pH 4.0) - acetonitrile as mobile phase at a flow-rate of 1.5 mL x min(-1). The mobile phase was splitted and 0.5 mL x min(-1) was introduced into MS. A tandem mass spectrometer equipped with electrospray ionization source was used as detector and operated in the negative ion mode. Quantification was performed using multiple reaction monitoring (MRM). The resolution of warfarin enantiomers is 1.56. The linear calibration curves for R-warfarin and S-warfarin both were obtained in the concentration range of 5 - 1 000 ng x mL(-1). Intra- and inter-day relative standard deviation (RSD) for R-warfarin and S-warfarin over the entire concentration range across three validation runs was both less than 10%, and relative error (RE) ranged from -4.9% to 0.7%, separately. The method herein described is effective and convenient, and suitable for the study of metabolic interaction between morinidazole and warfarin. The results showed that coadministration of warfarin with morinidazole did not affect the pharmacokinetics of either R-warfarin or S-warfarin.

2007-09-01·The Journal of Arthroplasty2区 · 医学

Incidence and Volume of Pelvic Osteolysis at Early Follow-up with Highly Cross-linked and Noncross-linked Polyethylene

2区 · 医学

Article

作者: Hiroshi Egawa ; Sarah Beykirch ; Serena B. Leung ; C. Anderson Engh ; Adam Stepniewski ; Charles A. Engh

Highly cross-linked polyethylene has shown decreased wear rates as compared to conventional polyethylene. However, the impact of this decrease on the occurrence of osteolysis remains uncertain. Forty hips implanted with noncross-linked Enduron and 36 implanted with 5-Mrad cross-linked Marathon polyethylene had a computed tomography at a minimum of 5 years after arthroplasty. Polyethylene wear, osteolysis incidence, location, and volume were compared. The incidence of osteolysis was statistically greater for patients with noncross-linked Enduron (11/40, 28%) compared to patients with the moderately cross-linked Marathon (3/36, 8%; P = .04). The average lesion volume for hips with Enduron liners (7.5 +/- 6.7 cm(3)) was significantly greater than the average lesion volume for hips implanted with Marathon liners (1.2 +/- 0.1 cm(3), P = .01). Marathon cross-linked polyethylene has shown to have a decreased incidence and volume of pelvic osteolysis. Longer follow-up is necessary to determine if Marathon cross-linked polyethylene will continue to demonstrate the encouraging improved wear and osteolysis characteristics.

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