title: Hip Resurfacing Using Highly Cross-linked Polyethylene: Prospective Study Results at 8.5 Years.
abstract: Hip resurfacing is an option to consider when treating younger, more active patients. Advantages over total hip arthroplasty include a more normal gait and a lower incidence of thigh pain.
  
  
  
  In this prospective study, 190 hip resurfacing procedures (164 participants) were performed using a cobalt-chromium femoral component and a cementless acetabular cup with a 3.8-mm highly cross-linked polyethylene acetabular liner.
  
  
  
  The mean follow-up was 8.5 (range, 7-10) years. Two participants were lost to follow-up and 2 died. One participant underwent successful revision surgery for acetabular loosening. Four participants underwent successful revision to a total hip arthroplasty because of femoral neck fracture (2), femoral loosening, or infection. The Kaplan-Meier survivorship was 97%. Acetabular bone conservation was assessed using computed tomography by measuring the medial acetabular wall. The mean thickness was 9 mm. Femoral bone was well preserved with a mean head:neck ratio of 1.37. There were 4 (2%) osteolytic defects up to 0.9 cm(3) on computed tomography and no instances of impending polyethylene wear-through. Seven polyethylene retrievals had a measured wear rate of 0.05 mm/y.
  
  
  
  Hip resurfacing using a highly cross-linked polyethylene acetabular component is a reliable procedure. Both femoral and acetabular bones are reasonably preserved compared with prior resurfacing methods. The low incidence of osteolysis and the low rate of wear found on retrievals suggest that many years of use in highly active patients is possible.
authors.affiliation: Hansjörg Wyss Hip and Pelvis Center, Swedish Medical Center, Seattle, Washington 98104.
authors.forename: James W
authors.initials: JW
authors.lastname: Pritchett
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D001178:Arthroplasty / Q000295:instrumentation*; D001847:Bone Diseases; D002857:Chromium; D003035:Cobalt; D005260:Female; D005265:Femoral Neck Fractures; D005269:Femur / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000453:epidemiology* / Q000209:etiology; D020959:Polyethylene; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D014861:Washington / Q000453:epidemiology
chemical_list: D002857:Chromium; D003035:Cobalt; D020959:Polyethylene
keywords: conservative hip implant arthroplasty; highly cross-linked polyethylene; hip resurfacing; implant survivorship; polyethylene wear