Manufacturing, oxidation, mechanical properties and clinical performance of highly cross-linked polyethylene in total hip arthroplasty

Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Gurpreet SinghBrent Lanting

Abstract

Ultra-high molecular weight polyethylene (UHMWPE) continues to be the gold standard bearing surface in total hip arthroplasty (THA) for nearly 5 decades. Highly cross-linked UHMWPE (HXLPE) was adapted for routine use in the early 2000s to reduce the revision rates related to wear, osteolysis, and aseptic loosening resulting from conventional UHMWPE wear. Since its inception, consistent evidence showing reduced wear rates and osteolysis supports the use of HXLPE in THA. High quality studies demonstrating the advantage in long term survivorship of HXLPE over conventional UHMWPE are emerging. Though retrieval studies have demonstrated evidence of in vivo oxidation and fatigue related damage at the rim of the first generation HXLPE liners, clinical significance of this remains to be seen. Second-generation sequentially annealed and vitamin E containing HXLPE liners demonstrate improved mechanical properties, resistance to oxidation, and equivalent wear rates in comparison to their first-generation counterparts, but long term success remains to be seen.

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Citations

May 16, 2020·SICOT-J·Jean Langlois, Moussa Hamadouche
Dec 14, 2019·Bone & Joint Research·Hasan R MohammadStephen J Mellon
Feb 11, 2021·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Volker OttenKjell G Nilsson
Nov 19, 2020·EFORT Open Reviews·Georgios TsikandylakisJohan Kärrholm

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Methods Mentioned

BETA
thermal treatment
total hip arthroplasty
infrared spectroscopy

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