Published in:
01-12-2010 | Symposium: Papers Presented at the 2009 Closed Meeting of the International Hip Society
Highly Crosslinked Polyethylene Reduces Wear in Total Hip Arthroplasty at 5 Years
Published in: Clinical Orthopaedics and Related Research® | Issue 12/2010
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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.
Questions/purposes
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.
Level of Evidence
Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.