Abstract
The emergence of highly cross-linked polyethylene (HCLPE) has drastically improved
survivorship of implants used in total hip arthroplasty (THA), as demonstrated by
midterm outcomes. However, there is limited data evaluating long-term outcomes and
wear rates of these liners. Therefore, the aim of this study is to evaluate the longest-to-date
follow-up of a specific second-generation HCLPE liner, the progression of wear rate,
and its relation to acetabular cup positioning. A retrospective study was conducted
on patients who underwent THA between January 2001 and December 2005 using a specific
second-generation HCLPE liner. Annual liner wear rate (mm/year) was calculated in
this group as well as acetabular positioning through abduction angle (degrees). Failures
and reason for failures such as periprosthetic fracture, dislocation, and osteolysis
were noted when applicable. Forty hips of 35 patients were included in this study
with a clinical and radiographic follow-up of 13.4 ± 2.2 years (range: 10.0–16.7 years).
Linear and volumetric wear rates were calculated to be 0.037 ± 0.020 mm/year and 22.94 ± 12.07 mm3/year, respectively. No radiographic femoral or acetabular osteolysis was observed
in any of the cases. One patient required revision due to complications unrelated
to the liner. No significant relationship could be established for acetabular component
abduction angle and linear wear rate (p = 0.690, Spearman's rho = 0.03). Our study demonstrates comparable liner wear rates
to that of other second-generation HCLPE liners in long-term follow-up. The XLPE liner
continues to exhibit minimal progression of linear wear when compared with previous
midterm studies and maintains a low rate of postoperative complications requiring
revision THA surgery. Further studies are warranted to assess long-term wear and survivorship
between this specific liner and comparable HCLPE models.
Keywords
HCLPE - highly cross-linked polyethylene - XLPE - survivorship - liner - total hip
arthroplasty - THA - second generation
