In Vivo Performance of Moderately Crosslinked, Thermally Treated Polyethylene in a Prospective Randomized Controlled Primary Total Knee Arthroplasty Trial

Cross-linked bearings have been developed for use in total knee arthroplasty that exhibit improved wear properties, but at the expense of a decrease in mechanical strength of the cross-linked material. Adoption has been slow due to fears of mechanical failure secondary to this alteration in mechanical properties. This prospective, randomized study compared mid-term survivorship, clinical and radiographic results of a conventional polyethylene (GVF) to a cross-linked polyethylene (XLK) in total knee prostheses of the same design. At minimum 5-year follow-up there was no difference in survivorship, clinical performance or radiographic findings between the groups. There were no revisions for polyethylene wear, osteolysis or tibial insert dissociation. Most importantly, there were no revisions for mechanical failure or fracture of the polyethylene bearing in either group.