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Reasons for Revision of First-Generation Highly Cross-Linked Polyethylenes
Journal article   Open access   Peer reviewed

Reasons for Revision of First-Generation Highly Cross-Linked Polyethylenes

Steven M. Kurtz, Francisco J. Medel, Daniel W. MacDonald, Javad Parvizi, Matthew J. Kraay and Clare M. Rimnac
The Journal of arthroplasty, v 25(6), pp 67-74
2010
DOI: https://doi.org/10.1016/j.arth.2010.04.018
PMID: 20541895
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://europepmc.org/articles/pmc2946323View
Accepted (AM) Open Open Access (License Unspecified)

Abstract

cross-linking revision total hip arthroplasty UHMWPE ultra–high molecular weight polyethylene wear
Over a 10-year period, we prospectively evaluated the reasons for revision of contemporary and highly cross-linked polyethylene formulations in a multicenter retrieval program. Two hundred twelve consecutive retrievals were classified as conventional gamma inert sterilized (n = 37), annealed (Crossfire [Stryker Orthopedics, Mahwah, NJ], n = 72), or remelted (Longevity [Zimmer ,Warsaw, Ind], XLPE [Smith and Nephew, Memphis, Tenn], Durasul [Zimmer, Warsaw, Ind], n = 103) liners. The most frequent reasons for revision were loosening (35%), instability (28%), and infection (21%) and were not related to polyethylene formulation ( P = .17). Annealed and remelted liners had comparable linear penetration rates (0.03 and 0.04 mm/y, respectively, on average), and these were significantly lower than the rate in conventional retrievals (0.11 mm/y, P ≤ .0005). This retrieval study including first-generation highly cross-linked liners demonstrated lower wear than conventional polyethylene. Although loosening remained as the most prevalent reason for revision, we could not demonstrate a relationship between wear and loosening. The long-term clinical performance of first-generation highly cross-linked liners remains promising based on the midterm outcomes of the components documented in this study.

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Domestic collaboration
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Orthopedics
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