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Second-generation highly cross-linked X3™ polyethylene wear: a preliminary radiostereometric analysis study
David G Campbell1, John R Field, Stuart A Callary
1Wakefield Orthopaedic Clinic, 270 Wakefield Street, Adelaide, SA, 5000, Australia. hipknee@tpg.com.au
Clinical Orthopaedics and Related Research
|February 13, 2010
Summary
Early clinical wear of second-generation highly cross-linked polyethylene liners is minimal, showing promising results for hip implant longevity. Further follow-up is needed to confirm these encouraging findings in total hip arthroplasty.
Area of Science:
- Biomaterials science
- Orthopedic surgery
- Medical device technology
Background:
- First-generation highly cross-linked polyethylene (HXLPE) liners reduced osteolysis but showed cracking and oxidation.
- Second-generation HXLPE offers improved wear, mechanical properties, and oxidation resistance in vitro.
- Clinical performance data for second-generation HXLPE is currently unavailable.
Purpose of the Study:
- To evaluate the early clinical wear of a second-generation HXLPE liner.
- To compare clinical wear with hip simulator data and first-generation HXLPE liners.
Main Methods:
- Prospective cohort study of 21 patients undergoing hip arthroplasty.
- Femoral head penetration measured for 19 patients at 6 months, 1 year, and 2 years postoperatively.
Main Results:
- Median proximal head penetration was 0.009 mm at 1 year and 0.024 mm at 2 years.
- Median 2-D head penetration was 0.083 mm at 1 year and 0.060 mm at 2 years.
- Median wear rate between years 1 and 2 was 0.015 mm/year.
Conclusions:
- Clinical wear rate aligns with in vitro data but is below the detection threshold.
- Low wear levels are encouraging for the long-term clinical performance of second-generation HXLPE.
- Extended follow-up is necessary to quantify wear clinically.
