Clinical Orthopaedics and Related Research®

, Volume 468, Issue 12, pp 3228–3233 | Cite as

Highly Crosslinked Polyethylene Reduces Wear in Total Hip Arthroplasty at 5 Years

  • Jonathan Mutimer
  • Peter A. Devane
  • Kathryn Adams
  • J. Geoffrey Horne
Symposium: Papers Presented at the 2009 Closed Meeting of the International Hip Society

Abstract

Background

Although hip arthroplasty reliably relieves pain and improves function, problems have arisen with wear and osteolysis. Highly crosslinked polyethylene has been developed to address this problem although at present there is limited clinical evidence it does so longer term.

Questions/purposes

We compared the in vivo wear of standard versus highly crosslinked polyethylene (HXLP) in primary total hip arthroplasty at a minimum of 5-year followup.

Methods

We enrolled 122 patients in a prospective, double-blinded, randomized trial and followed them annually to assess their progress. Annual radiographs were analyzed using previously validated edge detection software to assess for two-dimensional, three-dimensional, and volumetric wear. The mean follow up was 5.5 years (range, 4.1 to 7 years).

Results

The two-dimensional wear measurements for HXLP showed lower wear compared to the conventional group (0.05 mm/year versus 0.26 mm/year, respectively). Three-dimensional and volumetric wear were similarly lower in the HXLP group.

Conclusions

Highly crosslinked polyethylene undergoes substantially less wear than conventional polyethylene at medium term. The effect of hip arthroplasty longevity will need to be assessed with longer-term studies, but this may lead to a decreased need for revision as a result of less wear and osteolysis.

Level of Evidence

Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Notes

Acknowledgments

We thank James Stanley, Department of Public Health, Wellington School of Medicine (Wellington, New Zealand), for his assistance with statistical analysis of the data.

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Copyright information

© The Association of Bone and Joint Surgeons® 2010

Authors and Affiliations

  • Jonathan Mutimer
    • 1
    • 2
  • Peter A. Devane
    • 2
  • Kathryn Adams
    • 2
  • J. Geoffrey Horne
    • 2
  1. 1.Cheltenham General HospitalCheltenhamEngland, UK
  2. 2.Division of Orthopedic Surgery, Department of SurgeryWellington School of MedicineWellingtonNew Zealand

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