title: Highly Cross-linked Polyethylene Provides Decreased Osteolysis and Reoperation at Minimum 10-Year Follow-Up.
abstract: Highly cross-linked polyethylene was introduced to decrease periprosthetic osteolysis and reoperation, but this has not been conclusively proven.
  
  
  
  One surgeon performed 513 consecutive primary total hip arthroplasties (450 patients) using 1 modern, cementless, titanium-mesh acetabular component with screw fixation. This study analyzed the differences in the rate of reoperation and incidence of osteolysis between 133 hips with standard and 112 hips with highly cross-linked polyethylene at minimum 10-year follow-up time.
  
  
  
  Of the entire cohort of 513 hips, no acetabular component was removed or revised for aseptic loosening. There were significantly more reoperations in the cohort with standard polyethylene (11 of 133, 8%) than highly cross-linked polyethylene (1 of 112, 1%; P = .03). Osteolysis was seen in 24% (32 of 133 hips) with standard polyethylene, compared with 13% (15 of 112 hips) with highly cross-linked polyethylene (P = .02). These differences occurred despite the presence of patients with greater BMI and higher activity in the cohort with highly cross-linked polyethylene.
  
  
  
  We continue to use this acetabular component with highly cross-linked polyethylene. Longer follow-up is required to determine the progression of osteolysis.
authors.affiliation: Department of Orthopedic Surgery, Chapel Hill Orthopedics Surgery and Sports Medicine, Chapel Hill, North Carolina.
authors.forename: Paul F
authors.initials: PF
authors.lastname: Lachiewicz
authors.affiliation: Department of Orthopedic Surgery, Chapel Hill Orthopedics Surgery and Sports Medicine, Chapel Hill, North Carolina.
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Soileau
mesh_terms: D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects* / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D010014:Osteolysis / Q000453:epidemiology* / Q000209:etiology; D020959:Polyethylene / Q000009:adverse effects* / Q000737:chemistry; D011475:Prosthesis Failure; D012086:Reoperation / Q000706:statistics & numerical data*; D014025:Titanium
chemical_list: D020959:Polyethylene; D014025:Titanium
keywords: highly cross-linked polyethylene; osteolysis; reoperation; total hip arthroplasty; uncemented acetabulum