Highly Crosslinked Polyethylene In Total Hip Arthroplasty

Highly cross-linked polyethylene has been shown to reduce wear rates on tribological simulators and appears to represent a significant improvement over conventional polyethylene. The measurement of in vivo wear of acetabular bearing surfaces, especially at wear rates as low as those predicted on simulators, is difficult to measure with conventional techniques. The difficulty in assessing outcome is magnified by the fact that each manufacturer of highly cross-linked polyethylene uses a different formula to produce a unique product. However, computer enhanced wear estimation programs, in addition to radiostereometric analysis have consistently demonstrated reduced wear rates in vivo, with an associated decrease in osteolysis. Fractures of the material in vivo appear rare. While the mid term in vivo results are very promising, long-term outcomes are necessary to fully assess the efficacy of these materials in total hip arthroplasty.