Wear of a highly cross-linked polyethylene liner: a preliminary RSA study

  • David Campbell
  • Graham Mercer
  • Kjell-Gunnar Nilsson
  • Vanessa Wells
  • John R. Field
  • Stuart A. Callary
Original Article


Wear induced peri-prosthetic osteolysis and aseptic loosening remain the major contributing factors to failure of total hip arthroplasty. To reduce wear particles from acetabular liners, the process of polyethylene cross-linking has been modified. In this study, we examine the wear of Marathon™ acetabular liners using Radiostereometric Analysis. Thirty patients were enrolled in a prospective cohort study. Femoral head penetration was calculated for 25 patients at 6 months, 1 and 2 years postoperatively. The mean proximal head penetration was 0.067 mm at 6 months, 0.113 mm at 1 year and 0.120 mm at 2 years. The mean three-dimensional femoral head penetration was 0.240 mm at 6 months, 0.230 mm at 1 year and 0.232 mm at 2 years. For both parameters, there was no measurable wear between 1 and 2 years, and the mean annual linear wear was less than 0.06 mm/year, which is less than the suggested osteolysis threshold for polyethylene. All patients demonstrated a dramatic improvement in clinical scores. These results were comparable with other studies that used alternative techniques with conventional radiography to evaluate wear for Marathon™. Long-term studies using the RSA method are recommended to further quantify the clinical performance of this polyethylene liner.


Hip Wear RSA Polyethylene Radiostereometric analysis Cross-linked 



The authors wish to thank Frankie Clark for her assistance with collection of patient data in this study. The authors wish to thank Alexandra Pearce for her assistance with preparation of the manuscript.


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • David Campbell
    • 1
  • Graham Mercer
    • 1
  • Kjell-Gunnar Nilsson
    • 2
  • Vanessa Wells
    • 1
  • John R. Field
    • 3
  • Stuart A. Callary
    • 4
  1. 1.Orthopaedic UnitRepatriation General HospitalAdelaideAustralia
  2. 2.Department of OrthopaedicsUmeå University HospitalUmeåSweden
  3. 3.CORe: Comparative Orthopaedic Research Surgical FacilityFlinders UniversityAdelaideAustralia
  4. 4.Department of Orthopaedics and TraumaRoyal Adelaide HospitalAdelaideAustralia

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