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Review Question - QID 3210

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QID 3210 (Type "3210" in App Search)
A new biomaterial has been designed for hard on soft bearings in total hip arthroplasty. The implant company claims this new material has a lower wear rate and greater toughness than highly cross linked polyethylene. Which of the following studies would most accurately evaluate wear between the two materials?

Retrospective review of each material with immediate post-operative radiographs compared to annual follow-up radiographs

2%

42/2677

Prospective trial comparing each material with radiostereometric analysis

79%

2113/2677

Prospective trial comparing each material with annual CT scans

3%

92/2677

Prospective trial comparing each material with computer-assisted edge-detection radiographs

15%

405/2677

Retrospective trial comparing each material with computer-assisted edge-detection radiographs

1%

16/2677

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Radiostereometric analysis is the most effective method to evaluate polyethylene wear in arthroplasty. Radiopaque tantalum beads are inserted into the bone in strategic positions surrounding the implants. An immediate post-operative film records the position of the beads. The construct can then be followed with repeated radiographs over time by evaluating the position of the components relative to the beads.

Bragdon et al used radiostereometric analysis to compare wear rates of highly cross linked polyethylene with 28 mm and 36 mm femoral heads. No differences were discovered in femoral head penetration between the two groups.

McCalden et al summarizes the different methods available to evaluate polyethylene wear following total hip arthroplasty. Notably, radiostereometric analysis is the most accurate and precise, but is also expensive, requires technical expertise, and can only be used in a prospective manner.

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