Abstract
IntroductionThe purpose of this study was (1) to compare early wear rates in bedding-in periods of two highly cross-linked polyethylene liners frequently used in THA and (2) to evaluate risk factors indicating a possible higher wear rate.Materials and methods1120 patients who received a Crossfire or a Marathon highly cross-linked (HXLPE) ultra-high-molecular-weight polyethylene liner in primary THA at our Department between 2004 and 2018 were retrospectively reviewed. Patients with (1) only alumina heads on HXLPE acetabular bearings, (2) a minimum of four radiographs per patient for EBRA analysis, (3) no osteolysis around the acetabular cup and (4) no dislocations that occurred during the study period were included.ResultsA total of 328 patients (female: 183; male: 145; Marathon: 179; Crossfire: 149) fulfilled the inclusion criteria. Mean follow-up was 24 (range 7–51) months. With 0.22 (SD 0.27) mm mean total wear for the Marathon was three times greater than for the Crossfire, namely 0.07 (SD 0.14) mm. Mean cup migration during the investigated follow-up period was 0.7 (SD 0.8) mm for the Pinnacle and 0.5 mm (SD 0.7) for the Trident PSL cups.ConclusionInitial early wear of highly cross-linked polyethylene in combination with alumina heads differs strongly between products. Long-term survivorship of these liners should be observed to determine whether early wear has an impact on aseptic loosening.Level of evidenceLevel III (retrospective comparative study with prospective cohort).
Highlights
The purpose of this study was (1) to compare early wear rates in bedding-in periods of two highly cross-linked polyethylene liners frequently used in total hip arthroplasty (THA) and (2) to evaluate risk factors indicating a possible higher wear rate
To reduce wear and improve the longevity of THA, highly cross-linked polyethylene liners were introduced for clinical use in 1998 and emerged as an alternative bearing [13]
All Crossfire liners were used in Trident PSL cups (Stryker Orthopaedics, Mahwah, NJ, USA) and all Marathon liners were used in Pinnacle cups (DePuy Synthes, Warsaw, IN, USA)
Summary
The purpose of this study was (1) to compare early wear rates in bedding-in periods of two highly cross-linked polyethylene liners frequently used in THA and (2) to evaluate risk factors indicating a possible higher wear rate. Materials and methods 1120 patients who received a Crossfire or a Marathon highly cross-linked (HXLPE) ultra-highmolecular-weight polyethylene liner in primary THA at our Department between 2004 and 2018 were retrospectively reviewed. According to the current literature, cementless and cemented acetabular fixation show promising long-term results for up to 35 years [4,5,6]. Despite this improvement in fixation and the overall clinical success. To reduce wear and improve the longevity of THA, highly cross-linked polyethylene liners were introduced for clinical use in 1998 and emerged as an alternative bearing [13]. In midterm studies of the highly cross-linked polyethylenes
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