Wear Analysis of Highly Cross-Linked Polyethylene in Total Hip Arthroplasty

  • Charles R. BragdonEmail author
  • Michael Doerner
  • Henrik Malchau


Three hundred and eighty-five primary THAs (355 patients) in which HXLPE liners (Longevity or Durasul, Zimmer Inc.) with either 22, 26, 28 or 32 mm femoral heads were implanted between January 1, 1999 and December 31, 2002. The clinical measures used to evaluate these patients are the Harris hip, EQ-5D, and UCLA activity scores. In addition to conventional plain radiograph assessment, the Martell method was used to measure head penetration over time. A matched set of 186 THAs (129 patients) with 26 and 28 mm head sizes coupled with conventional gamma sterilized in air polyethylene with a minimum of 7 years follow-up was identified as a wear measurement control group.

No components show radiographic loosening, failure or fracture. There are no osteolytic lesions around the cup or stem. No revisions have been performed for polyethylene wear or liner fracture. The average scores (±StDev) for the Harris hip, EQ-5D, and UCLA activity surveys were 86.91  ±  15.61, 80.01  ±  16.81, 6.13  ±  2.06 respectively. Based on the longest follow-up film of individuals with a minimum 7 year follow-up, the average head penetration rates were 7.2  ±  78.0 and 4.3  ±  87.3 mm/year for 28 and 32 mm heads respectively. There was no significant difference in the head penetration rates between the 28 and 32 mm heads. This average wear rate was significantly different than that of a match set of conventional PE liners coupled with 26 and 38 mm heads (97  ±  140.7 mm/year, p  <  0.0001).


Femoral Head Femoral Head Size Head Penetration Diameter Femoral Head Conventional Polyethylene 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.


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Copyright information

© Springer Berlin Heidelberg 2011

Authors and Affiliations

  • Charles R. Bragdon
    • 1
    Email author
  • Michael Doerner
    • 1
  • Henrik Malchau
    • 1
  1. 1.The Harris Orthopaedic LaboratoryMassachusetts General HospitalBostonUSA

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