Minimum 6-year followup of highly cross-linked polyethylene in THA

Abstract

To reduce wear rates and particulate debris, highly cross-linked polyethylene has been in use in total hip arthroplasty for 8 years. We designed this followup study to primarily determine the total penetration rate of the femoral head and the steady-state wear rate of cross-linked polyethylene in patients undergoing primary total hip arthroplasty. We retrospectively reviewed data from 182 patients (200 hips) with a minimum 6-year followup (mean, 6.9 years; range, 6-8 years) and an average age of 60.2 years at surgery. The average Harris hip score, University of California-Los Angeles activity score, and WOMAC score were 91.1, 6.3, and 11.3, respectively. Radiographic evaluation showed no evidence of loosening or osteolytic lesions around the cup or stem. No revisions were performed for polyethylene wear or liner fracture. The average steady-state wear rate was -0.002 +/- 0.01 mm per year and -0.026 +/- 0.13 mm per year for 28-mm and 32-mm head sizes, respectively. We observed no correlation between the total wear rate and femoral head size, brand of polyethylene, age, gender, primary diagnosis, mode of fixation, surgical approach, University of California-Los Angeles activity score, Harris hip score, or WOMAC. Highly cross-linked polyethylene liners are associated with excellent midterm clinical, radiographic, and wear results in this group of patients.