title: In Vivo Performance of Moderately Crosslinked, Thermally Treated Polyethylene in a Prospective Randomized Controlled Primary Total Knee Arthroplasty Trial.
abstract: Cross-linked bearings have been developed for use in total knee arthroplasty that exhibit improved wear properties, but at the expense of a decrease in mechanical strength of the cross-linked material. Adoption has been slow due to fears of mechanical failure secondary to this alteration in mechanical properties. This prospective, randomized study compared mid-term survivorship, clinical and radiographic results of a conventional polyethylene (GVF) to a cross-linked polyethylene (XLK) in total knee prostheses of the same design. At minimum 5-year follow-up there was no difference in survivorship, clinical performance or radiographic findings between the groups. There were no revisions for polyethylene wear, osteolysis or tibial insert dissociation. Most importantly, there were no revisions for mechanical failure or fracture of the polyethylene bearing in either group.
authors.affiliation: Orthopaedic Center of the Rockies, Fort Collins, Colorado.
authors.forename: Kirk A
authors.initials: KA
authors.lastname: Kindsfater
authors.affiliation: The Arthroplasty Foundation, Louisville, Kentucky.
authors.forename: Donald
authors.initials: D
authors.lastname: Pomeroy
authors.affiliation: University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Clark
authors.affiliation: Zonal Concepts, Wesley Chapel, Florida.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Gruen
authors.affiliation: DePuy Synthes Joint Reconstruction, Warsaw, Indiana.
authors.forename: Jeff
authors.initials: J
authors.lastname: Murphy
authors.affiliation: DePuy Synthes Joint Reconstruction, Warsaw, Indiana.
authors.forename: Sam
authors.initials: S
authors.lastname: Himden
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D001672:Biocompatible Materials; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D020959:Polyethylene; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation
chemical_list: D001672:Biocompatible Materials; D020959:Polyethylene
keywords: fixed bearing; gamma irradiation; joint replacement; polyethylene; randomized controlled trial; total knee arthroplasty