Abstract 31

RELATIONSHIP BETWEEN PROGRESSION OF OSTEOLYSIS AND POLYETHYLENE WEAR AND PATIENT-RELATED FACTORS

¹Stamenkov R, Howie D, Taylor J, Findlay D, Kourlis G, McGee M, Neale S, Pannach S

¹Dept. Orthopaedics & Trauma, Royal Adelaide Hospital, The University of Adelaide

Knowledge of the extend and progression of osteolysis is important in deciding the timing of surgical intervention, the type of surgery and also for monitoring the potential effects of medical treatments. The aim of this study was to use quantitative computed tomography (CT), with wear and migration analyses, to determine the rate of progression of osteolysis and to examine the relationship between osteolysis and polyethylene wear and patient-related variables.

The annual progression of osteolysis adjacent to 19 well-fixed Harris-Galante acetabular components was determined. Migration analyses were used to exclude cases with migrated components. Volumetric polyethylene wear was determined from digitised X-rays using the Polyware software program. Patient-related factors including age, gender, BMI, activity levels, co morbidities, and joint pain and function were recorded from our Joint Replacement Database.

Lesions in many of these patients were relatively quiescent, while others progressed markedly over a one year period. There was a statistically significant association between progression of osteolysis and total polyethylene wear, total polyethylene wear rate and volumetric polyethylene wear rate and volumetric polyethylene wear in the 12 month period between CT scans (p=0.026, p=0.025 and p=0.035 respectively). None of the other covariates examined was significantly associated with the progression of osteolysis.

CT measurement of osteolysis progression and accurate estimates of cup wear and stability provides important information to guide clinical management of patients with periprosthetic osteolysis.

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