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Highly Cross-Linked Polyethylene Reduces Wear and Revision Rates in Total Hip Arthroplasty: A 10-Year Double-Blinded
Peter A Devane1, James Geoffrey Horne, Alexander Ashmore
11Wellington Hospital, Wellington, New Zealand 2Great Western Hospital, Swindon, United Kingdom 3Cheltenham General Hospital, Cheltenham, United Kingdom 4University of Otago, Wellington, New Zealand.
The Journal of Bone and Joint Surgery. American Volume
|October 18, 2017
Summary
Highly cross-linked polyethylene (XLPE) significantly reduces wear and osteolysis compared to conventional ultra-high molecular weight polyethylene (UHMWPE). This leads to improved implant survival rates in hip replacements at 10 years.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Medical device technology
Background:
- Conventional ultra-high molecular weight polyethylene (UHMWPE) wear causes osteolysis in hip replacements.
- Highly cross-linked polyethylene (XLPE) was developed to improve wear resistance.
Purpose of the Study:
- Compare in vivo wear rates and clinical outcomes of XLPE versus UHMWPE hip liners.
- Evaluate long-term (minimum 10 years) performance in a prospective, double-blinded, randomized controlled trial.
Main Methods:
- 122 patients randomized to XLPE or conventional UHMWPE liners.
- Clinical and radiographic assessments at minimum 10-year follow-up.
- Analysis of wear rates, osteolysis, and revision rates.
Main Results:
- XLPE demonstrated significantly lower 3-D wear rates (0.03 mm/yr vs. 0.27 mm/yr).
- Lower prevalence of osteolysis (8% vs. 38%) and revision rates (1.9% vs. 14.6%) in the XLPE group.
- No significant difference in clinical scores between groups.
Conclusions:
- XLPE liners significantly reduce wear and osteolysis compared to conventional UHMWPE.
- XLPE is associated with a greater implant survival rate at 10 years.