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Caleb W. Grote. 1 Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas.
Paul C. Cowan. 2 Department of Orthopedic Surgery, Drisko, Fee and Parkins, Kansas City, Missouri.
David W. Anderson. 3 Department of Orthopedic Surgery, Kansas City Joint Replacement at Menorah Medical Center, Overland Park, Kansas.
Kimberly J. Templeton. 1 Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas.
© Caleb W. Grote et al. 2018; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
*, Address correspondence to: Kimberly J. Templeton, MD, Department of Orthopedic Surgery, University of Kansas Medical Center, 4000 Cambridge Street, MS 3017, Kansas City, KS 66160; E-mail: [email protected]
Introduction
Total hip arthroplasty (THA) has become a widely used treatment for alleviating pain and disability secondary to degenerative joint disease of the hip. Women are at increased risk of osteoarthritis than men.1 There are currently an estimated 2.5 million people in the United States living with a THA.2
Over 200,000 THAs are performed in the United States each year, and this number is expected to rise to nearly 570,000 by 2030.3 While many implant variations have been described, the overall design has remained constant. This consists of a femoral stem that is inserted into the proximal femur and a femoral head that is attached to the stem, which then articulates with a cup that is set into the native acetabulum.
Early implant designs involved a metal femoral head articulation with a "conventional" plastic (polyethylene) liner within a metal cup. Early "conventional" polyethylene was associated with higher rates of asymmetric wear, particle debris, osteolysis, and implant failure.4 To address these concerns, implants with superior wear characteristics were developed. In the late 1990s, gamma radiation and thermal treatments were used to create highly crosslinked polyethylene, which showed significant improvement over "conventional" polyethylene and is commonly used in implants today and considered the "gold standard."4
To further address issues seen with the conventional metal-on-polyethylene hip replacements, other bearing surfaces, termed "hard-on-hard," have been developed. These include ceramic-on-ceramic and metal-on-metal (MoM) designs. MoM...