Five-year Experience with Crossfire® Highly Cross-linked Polyethylene

Our purpose was to compare the clinical wear performance of highly cross-linked (Crossfire®) polyethylene with conventional (N2Vac™) polyethylene total hip bearings. We implanted 56 hips (47 patients) with Crossfire® acetabular bearing liners and compared their wear performance with 53 conventional polyethylene inserts. Wear and clinical data were collected retrospectively at a minimum 4-year and average 5-year followup. The linear femoral head penetration rate measured from plain radiographs was 0.055 mm/year ± 0.022 mm/year for the Crossfire® polyethylene and 0.138 mm/year ± 0.073 mm/year for the control, a reduction of 60% for the Crossfire® components. Calculated annual wear was 0.036 mm/year for the Crossfire® components and 0.131mm/year for the controls, a reduction of 72%. Radiographic review at most recent followup showed a reduction in erosive osteolytic lesions of the proximal femur for the Crossfire® components compared with controls, also suggesting a reduction in debris release for the Crossfire® components. Complications leading to revision were not seen in the Crossfire® or control groups. These clinical findings suggest that this particular highly cross-linked polyethylene can provide wear reduction and an alternate bearing surface for active patient populations.

Level of Evidence: Therapeutic study, Level III (retrospective comparative study). See the Guidelines for Authors for a complete description of levels of evidence.