Long-Term Reduction of Wear and Osteolysis with Cross-Linked PE? 13-Year Follow-up of a Prospectively Randomized Comparison with Conventional PE

  • Bernd Grimm
  • Alphons Tonino
  • Ide Christiaan Heyligers


Cross-linked polyethylene (PE) for total hip arthroplasty still lacks long-term clinical evidence about its sustained performance in wear reduction and its effect on reducing osteolysis, while concerns persist about oxidation and the higher osteolytic potential of the wear debris.

This 13 years follow-up of a randomized controlled trial (n48 patients) compares the first generation of a moderately cross-linked and annealed PE (Stryker Duration) to conventional, now “historic” PE by measuring wear as linear head penetration (Roman V 1.70) and counting osteolytic cysts on digital radiographs.

Wear rates were significantly (p = 0.005) lower for Duration (0.063 ± 0.027 mm/year) than conventional PE (0.122 ± 0.065 mm/year). This reduction (−48%) compared well to the original simulator prediction (−45%) and even increased with time (−30% at 5 years, −38% at 8 years, −42% at 10 years). Acetabular cysts were less frequent in the Duration (4/13 = 31%) than in conventional group (13/18 = 72%, p = 0.023).

No evidence of oxidative degradation or elevated osteolytic potential of the wear debris was found but reduced wear and less osteolysis at long follow-up.


Wear Rate Wear Particle Small Punch Test Linear Wear Rate Wear Reduction 
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.





Highly cross-linked polyethylene




Randomized controlled trial




Standard deviation


Ultra-high molecular weight polyethylene


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Copyright information

© EFORT 2012

Authors and Affiliations

  • Bernd Grimm
    • 1
  • Alphons Tonino
    • 1
  • Ide Christiaan Heyligers
    • 1
  1. 1.Department of Orthopaedic Surgery & Traumatology, Atrium Medical CenterAHORSE Research FoundationHeerlenThe Netherlands

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