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Recent update on crosslinked polyethylene in total hip arthroplasty
Jean Langlois1, Moussa Hamadouche2
1Centre Orthopédique Santy, 24, avenue Paul Santy, 69008 Lyon, France - Hôpital Privé Jean-Mermoz, 55, avenue Jean-Mermoz, 69008 Lyon, France.
SICOT-J
|May 16, 2020
Summary
First-generation crosslinked polyethylenes (XLPE) show high effectiveness over 15 years, even in young patients. Newer XLPE generations with antioxidants offer promising short-term results, but ongoing surveillance is essential due to reported failures.
Area of Science:
- Biomaterials Science
- Orthopedic Surgery
- Materials Engineering
Background:
- Crosslinked polyethylenes (XLPE) are widely used in joint replacements.
- Initial concerns about oxidation and brittleness have been addressed.
- Long-term clinical data demonstrate the efficacy of first-generation XLPE.
Purpose of the Study:
- To evaluate the long-term effectiveness and outcomes of various generations of crosslinked polyethylenes (XLPE) in total joint arthroplasty.
- To compare the performance of remelted versus annealed XLPE.
- To assess the results of second-generation XLPE, including those with antioxidants, in diverse clinical settings.
Main Methods:
- Review of clinical data and registry reports on first- and second-generation XLPE.
- Analysis of wear rates in remelted versus annealed XLPE.
- Evaluation of XLPE performance in challenging surgical scenarios like revision surgery and hip resurfacing.
Main Results:
- First-generation XLPE remains highly effective for at least 15 years, particularly in young, active individuals.
- Remelted XLPE may exhibit lower wear rates compared to annealed XLPE.
- Second-generation XLPE, incorporating antioxidants, shows encouraging short- to mid-term outcomes across various implant designs and surgical complexities.
- Promising results are noted even in challenging applications such as dual mobility cups and revision surgeries.
- However, some failures, including fractures, have been documented.
Conclusions:
- Crosslinked polyethylenes (XLPE) have demonstrated significant long-term success in joint arthroplasty.
- Advancements in second-generation XLPE, including antioxidant incorporation, show positive early results.
- Despite overall success, continued vigilance and surveillance are necessary to monitor for and address potential failures like fractures.
