Highly crosslinked polyethylene reduces wear in total hip arthroplasty at 5 years.
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.


OBJECTIVE
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.
Mutimer
Jonathan
J
Wakefield Hospitals, Wellington, New Zealand. jonmutimer@doctors.org.uk
Devane
Peter A
PA
Adams
Kathryn
K
Horne
J Geoffrey
JG
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D004311:Double-Blind Method; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D021621:Imaging, Three-Dimensional; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010014:Osteolysis / Q000209:etiology / Q000517:prevention & control; D020959:Polyethylene; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011857:Radiographic Image Interpretation, Computer-Assisted; D013314:Stress, Mechanical; D013997:Time Factors; D016896:Treatment Outcome
D020959:Polyethylene
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