Clinical Orthopaedics and Related Research®

, Volume 471, Issue 7, pp 2238–2244

Wear of a 5 Megarad Cross-linked Polyethylene Liner: A 6-year RSA Study

  • Stuart A. Callary
  • David G. Campbell
  • Graham Mercer
  • Kjell G. Nilsson
  • John R. Field
Clinical Research

DOI: 10.1007/s11999-013-2789-x

Cite this article as:
Callary, S.A., Campbell, D.G., Mercer, G. et al. Clin Orthop Relat Res (2013) 471: 2238. doi:10.1007/s11999-013-2789-x



One cross-linked polyethylene (XLPE) liner is manufactured using a lower dose of radiation, 5 Mrad, which may result in less cross-linking. The reported in vivo wear rate of this XLPE liner in patients undergoing THA has varied, and has included some patients in each reported cohort who had greater than 0.1 mm/year of wear, which is an historical threshold for osteolysis. Previous studies have measured wear on plain radiographs, an approach that has limited sensitivity.


We therefore measured the amount and direction of wear at 6 years using Radiostereometric analysis (RSA) in patients who had THAs that included a cross-linked polyethylene liner manufactured using 5 Mrad radiation.


We prospectively reviewed wear in 30 patients who underwent primary THAs with the same design of cross-linked acetabular liner and a 28-mm articulation. Tantalum markers were inserted during surgery and all patients had RSA radiographic examinations at 1 week, 6 months, 1, 2, and 6 years postoperatively.


The mean proximal, two-dimensional (2-D) and three-dimensional (3-D) wear rates calculated between 1 year and 6 years were 0.014, 0.014, and 0.018 mm/per year, respectively. The direction of the head penetration recorded between 1 week and 6 years was in a proximal direction for all patients, proximolateral for 16 of 24 patients, and proximomedial for eight of 24 patients.


The proximal, 2-D and 3-D wear of a XLPE liner produced using 5 Mrad of radiation was low but measurable by RSA after 6 years. No patients had proximal 2-D or 3-D wear rates exceeding 0.1 mm/year. Further followup is needed to evaluate the effect of XLPE wear particles on the development of long-term osteolysis.

Copyright information

© The Association of Bone and Joint Surgeons® 2013

Authors and Affiliations

  • Stuart A. Callary
    • 1
    • 2
  • David G. Campbell
    • 3
  • Graham Mercer
    • 3
  • Kjell G. Nilsson
    • 4
  • John R. Field
    • 5
  1. 1.Discipline of Orthopaedics and TraumaUniversity of AdelaideAdelaideAustralia
  2. 2.Department of Orthopaedics and TraumaRoyal Adelaide HospitalAdelaideAustralia
  3. 3.Orthopaedic UnitRepatriation General HospitalAdelaideAustralia
  4. 4.Department of OrthopaedicsUmeå UniversityUmeåSweden
  5. 5.Comparative Orthopaedic Research Surgical FacilityFlinders UniversityAdelaideAustralia

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