MPC-grafted highly cross-linked polyethylene liners retrieved from short-term total hip arthroplasty: Further evidences for the unsuitability of the MPC method

Nakasone et al. (2015), Sugano et al. (2016), and Tone et al. (2018).

reall

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resides in the fact that it deals with the limited number of four retrieved

CONC LU SION

Four HXLPE MPC-grafted retrieval liners were analyzed on their bearing surfaces in comparison with three as-received samples of the

same type. The two main purposes of this investigation were, as

F I G U R E 1 0 Schematic draft of (a) the pristine MPC-grafted liner

and (b) the in vivo alterations at its surface after peeling off of the

polymeric grafted layer

follows:

1 To evaluate whether the MPC layer had any role in reducing wear

or, at least, if it remained on the surface after short-term in vivo

exposure;

implantation in vivo. Conversely, the studied liners appeared to have

serious problems of surface oxidation due to a relatively large amount

2 To detect whether or not oxidation or other structural modifications occurred during service.

of free radicals created both during manufacturing and as a consequence of MPC peeling off. A more recent follow-up study which was

In all the short-term retrieval samples, we observed that the MPC

co-authored by a representative of Kyocera Medical Corp., performed

layer was completely peeled off from the bearing surface in both

on 80 patients which received such implants, reported no adverse

NWZs and MWZs. Furthermore, we observed oxidative degradation

reactions and lower wear rates when compared to not-grafted liners,

not only in the MWZ, but also in the NWZ of the samples. A general

but the study did not include controls and the outstandingly low aver-

trend of increase above the as-received samples could be found for

age wear rate measured (0.002 mm/year) resulted to be one order of

different kinds of oxidative species, but such increases were statisti-

magnitude lower than the data dispersion (0.023 mm/year), which

cally significant only for ester, carboxyl acid and ketone species

suggests the presence of (unrealistic) negative wear rate values or a

according to ATR-FTIR measurements.

仁二—WILEY_l_

2867

HOSOI ET AL.

In conclusion, the present results represent additional evidence

on short-term MPC-grafted retrieved liners, which sums up to those

of our previous study of three short-term retrievals (Jay &

Waller, 2014) and to a number of additional short-term retrievals

presented by other researchers (Stewart, 2010; Zhu et al., 2017).

Given this body of independent evidences, we now believe that MPC

grafting produces insignificant benefits in terms of wear and oxidation

as compared to conventional (i.e., nongrafted) HXLPE liners.

We thus recommend that the commercial presentation of the

MPC-grafted liners be updated into a more factual report of the actual

performance of this product for the sake of transparency toward both

patients and surgeons.

INS TITUTIONAL R EVIEW B OARD STATEMENT

This study has been approved by the Institutional Review Board (IRB)

of Mie University.

ORCID

Elia Marin

ehttps://orcid.org/0000-0002-0981-7821

RE FE R ENC E S

How to cite this article: Hosoi T, Hasegawa M, Tone S, et al.

MPC-grafted highly cross-linked polyethylene liners retrieved

from short-term total hip arthroplasty: Further evidences for

the unsuitability of the MPC method. J Biomed Mater Res.

2020;108B:2857–2867. https://doi.org/10.1002/jbm.b.

34617

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