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Thirteen- Year Evaluation of Highly Cross-Linked Polyethylene Articulating With Either 28-mm or 36-mm Femoral Heads Using Radiostereometric Analysis and Computerized Tomography

Journal article
Authors A. K. Nebergall
M. E. Greene
H. Rubash
Henrik Malchau
A. Troelsen
Ola Rolfson
Published in Journal of Arthroplasty
Volume 31
Issue 9
Pages S269-S276
ISSN 0883-5403
Publication year 2016
Published at Institute of Clinical Sciences, Department of Orthopaedics
Pages S269-S276
Language en
Keywords total hip arthroplasty, highly cross-linked polyethylene, radiostereometic analysis, computerized, molecular-weight polyethylene, total hip-arthroplasty, low-friction, arthroplasty, in-vivo wear, periprosthetic osteolysis, acetabular, components, size, replacement, dislocation
Subject categories Orthopedics


Background: The objective of this 13-year prospective evaluation of highly cross-linked ultra high molecular weight polyethylene (HXLPE) was to (1) assess the long-term wear of HXLPE articulating with 2 femoral head sizes using radiostereometric analysis (RSA) and to (2) determine if osteolysis is a concern with this material through the use of plain radiographs and computerized tomography (CT). Methods: All patients received a Longevity HXLPE liner with tantalum beads and either a 28-mm or 36-mm femoral head. Twelve patients (6 in each head size group) agreed to return for 13-year RSA, plain radiograph, and CT follow-up. The 1-year and 13-year plain radiographs as well as the CT scans were analyzed for the presence of osteolysis. Results: The 13-year mean +/- standard error steady-state wear was 0.05 +/- 0.02 mm with no significant increase over time or between the 2 head size groups. Two patients' CT scans showed radiolucent regions in the acetabulum of 4.51 cm(3) and 11.25 cm(3), respectively. In one patient, this area corresponded to a partially healed degenerative cyst treated with autograft during surgery. The second patient had an acetabular protrusio treated with autograft, and the CT scan revealed areas of remodeling of this graft. One patient's 13-year plain radiographs showed evidence of cup loosening and linear radiolucencies in zones 2 and 3. Conclusion: There was no evidence of significant wear over time using RSA. The CT scans did not show evidence of osteolysis due to wear particles. These results suggest that this material has reduced wear compared to conventional polyethylene, irrespective of head size.

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