Cross-linked ultra-high-molecular weight polyethylene liner and ceramic femoral head in total hip arthroplasty: a prospective study at 5 years follow-up

Background

Recent data indicate that enhanced wear resistance can be obtained with new cross-linked ultra-high-molecular weight polyethylene (CL-UHMWPE) liners, in comparison with previous-generation liners. The current prospective, cohort study was undertaken to analyse whether the use of a new CL-UHMWPE (Rexpol) results in a lower wear rate than ultra-high-molecular weight polyethylene (UHMWPE) in a group of similar patients undergoing total hip arthroplasty (THA). This study provides the first clinical data with this particular CL-UHMWPE.

Methods

Between January 2001 and December 2001, patients underwent THA with biconical threaded cups and ceramic femoral heads using either a CL-UHMWPE liner (n = 50) or a regular UHMWPE liner (n = 57). At the time of the final 5-year evaluation, there were 48 patients available in the CL-UHMWPE and 54 patients available in the UHMWPE group.

Results

After a mean 5.6 years follow-up, there were no significant differences between the groups in Harris Hip Score outcomes. However, there was a 69.1% decrease in wear at 5 years for the CL-UHMWPE group in comparison with the UHMWPE group (p < 0.01).

Conclusion

The use of CL-UHMWPE significantly reduced the risk of polyethylene wear in patients undergoing THA with biconical threaded cups and ceramic femoral heads. Further follow-up is needed to determine how this will influence long-term outcomes.