, Volume 11, Issue 2, pp 67-72,
Open Access This content is freely available online to anyone, anywhere at any time.
Date: 27 May 2010

Polyethylene in total hip arthroplasty: half a century in the limelight

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It is well known that polyethylene (PE) wear is the major limiting factor in longevity of primary total hip arthroplasty (THA) [1]. Many studies report that cup loosening due to wear is the most frequent reason for revision in the long term for both cemented and uncemented THA, especially in young and active patients [27]. To date, this phenomenon is known to produce osteolysis secondary to particle debris on both the acetabular and femoral sides [3, 811]. Ultrahigh molecular weight PE was introduced by Sir John Charnley in the early 1960s. He developed the low-friction arthroplasty (LFA) consisting of cemented fixation with a bearing surface of a 22.25-mm metallic femoral head and an all-PE cup [12]. That type of PE has been used for >40 years and is still the most frequent bearing surface used in total joint replacements.

Conventional PE is sterilized by gamma irradiation in air. This process offers the benefits of molecular cross-linking but can also produce free radicals that, in ...