Wear is Reduced in THA Performed with Highly Cross-linked Polyethylene

Highly cross-linked polyethylene (HCLPE) has been used extensively to decrease osteolysis and related implant failure in THA. We compared the wear rate of HCLPE and noncross-linked conventional PE (CPE) liners and the rate of radiographic calcar resorption and osteolysis in young patients (35–60 years of age) who underwent THA by one surgeon. Thirty-four patients (41 THAs) who received a hybrid THA using a HCLPE liner were match-paired for age, gender, body mass index, and diagnosis with a group of patients who underwent THA with identical implants but with a CPE liner. The minimum followup was 4 years (average, 5.3; range, 4–8 years). Using the Livermore measurement technique, the averages of total wear of the HCLPE and CPE liners were 0.01 mm (range, −0.23–0.4) and 0.64 mm (range, 0–1.7), respectively. The average annual wear was less for the HCLPE than the noncross-linked PE (0.002 mm, range, −0.05–0.1 versus 0.12 mm, range, 0–0.29, respectively). Four hips in the HCLPE group and 23 in the CPE group had calcar resorption measuring averages of 2.5 mm (range, 2–3) and 7.5 mm (range, 1.8–23.8), respectively. Periprosthetic osteolysis occurred in two and eight hips in the HCLPE and CPE groups, respectively. Longer followup is needed to determine if these findings will result in improved implant survivorship.