HIP
ISSN 1120-7000
HIP International
2018, Vol. 28(1) 53–58
© The Author(s) 2017
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DOI: 10.5301/hipint.5000521
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ORIGINAL RESEARCH ARTICLE
penetraton into the bearing of more than 0.1 mm/year
and unlikely in patents with head penetraton of less than
0.05 mm/year. Thus, alternatve bearings were urgently
needed to reduce wear and secondary osteolysis, thereby po-
tentally improving the long-term survivorship of the implant.
Marathon® polyethylene was developed by Depuy
Orthopaedics, Warsaw, USA (12) and was available for use with
the uncemented components from 1998. The polyethylene is
produced by a process of ram bar extrusion, irradiaton with
5 mrad, remeltng in a vacuum (thermal treatment at 155°C. for
24 hours), followed by machining of the fnal shape and terminal
sterilisaton with gas plasma (12). This produces a moderately
cross-linked HMWPE (high-molecular-weight polyethylene).
In 2006, Engh et al (13) reported, in a prospectve ran-
domised trial with a mean follow-up of 5.6 years, a 95% re-
ducton in linear wear in the Marathon® uncemented cup
when compared to the control group, which were conven-
tonal non-cross-linked Enduron polyethylene liners. The re-
ported wear rate was 0.01 ± 0.07 mm/year.
The cemented Marathon® acetabular component was in-
troduced in the UK market in 2007.
There are no studies in the literature documentng wear
rates of the cemented version. We report the medium term
results and wear rates of the Marathon® cemented acetabu-
lar component implanted at our insttuton between 2008
and 2009.
Wear rate and medium-term survival of a
cemented, moderately cross-linked
polyethylene acetabular prosthesis
Bilal M. Barkatali
1
, Dinesh P. Alexander
1
, Anil K. Gambhir
2
, Henry Wynn Jones
2
, Tim N. Board
2
1
Salford Royal Foundaton Teaching Hospital NHS Trust, Salford - UK
2
The Centre for Hip Surgery, Wrightngton, Wigan and Leigh NHS Foundaton Trust, Wigan - UK
Introducton
Osteolysis, secondary to partculate debris released from
the hip artculaton in metal on polyethylene bearings has
been the most important clinical problem limitng the lon-
gevity of total hip arthroplasty (1-5). Since the late 1990s,
cross-linked polyethylene has steadily replaced conventonal
polyethylene in hip arthroplasty (5). Highly cross-linked poly-
ethylene (HXLPE) has also come to be widely accepted by
surgeons as an alternatve to hard-on-hard bearings for im-
proving the wear resistance of hip arthroplasty (6). It appears
that HXLPE reduces the risk of osteolysis due to the improved
wear characteristcs which reduces partculate debris (7-10).
Dumbleton et al (11) demonstrated, from a review of the
literature, that osteolysis was likely in patents with head
ABSTRACT
Introducton: The moderately cross-linked Depuy Marathon® cemented acetabular component was introduced
into the UK in 2007. The wear rate for the previously introduced Marathon® uncemented acetabular component
has been reported to range from 0.06 to 0.01 mm/year.
The aim of this study was to present the medium-term results and wear rate of the Marathon® cemented pros-
thesis used in primary total hip arthroplasty.
Methods: 103 Marathon® cemented acetabular components were implanted between 2008 and 2009 in primary
arthroplasty, who were eligible for this study. All patents received a metal 28-mm head. Mean age was 68 years
(range 27-87). Mean clinical follow-up was 55 months (range 50-61). Mean radiological follow-up was 46 months
(range 24-57). Wear was calculated on AP radiographs using computer-assisted uni-radiographic technique.
Results: The mean wear was 0.37 mm (range 0.0-0.78 mm). The wear rate was calculated as 0.03 mm/year (95%
confdence interval 0.02-0.06). Postoperatve complicatons included deep vein thrombosis (2%) and dislocaton
(0.8%); there were no deep infectons. There were no revisions for failure of the Marathon® cemented acetabular
component.
Conclusions: The Marathon® cemented acetabular component demonstrates satsfactory wear rates and survi-
vorship at medium-term follow-up.
Accepted: March 22, 2017
Published online: December 1, 2017
Corresponding author:
Bilal M. Barkatali
Department of Trauma and Orthopaedics
Salford Royal Hospital
Stot Lane
Salford, M6 8HD, UK
bilalb1@hotmail.com