THA with Highly Cross-linked Polyethylene in Patients 50 Years or Younger

Derek S. Shia MD, John C. Clohisy MD, Mark F. Schinsky MD, John M. Martell MD, William J. Maloney MD

Clinical Orthopaedics and Related Research. Received: 20 June 2008 / Accepted: 19 December 2008 / Published online: 14 January 2009. 467:2059–2065. DOI 10.1007/s11999-008-0697-2

Abstract - Highly cross-linked polyethylene has been associated with low in vitro wear, but also has decreased in vitro ultimate yield strength.We therefore asked whether highly cross-linked polyethylene would result in lower outcome scores, wear, or early failure in a young patient population. Seventy THAs in 64 patients were performed using a highly cross-linked (electron beam-irradiated to 9 Mrads) acetabular liner and a cobalt-chrome femoral head. The average age of the patients at surgery was 41 years (range, 19–50 years). The minimum followup was 2.4 years (average, 4 years; range, 2.4–6.5 years). We recorded demographic and clinical data, including Harris hip score. Polyethylene wear measurements were analyzed with a validated, computer-assisted, edge detection method. The average Harris hip score improved from 53 to 92 at last followup. There was no evidence of acetabular or femoral loss of fixation, subsidence, or loosening. Linear wear was undetectable at this followup interval. No patient experienced catastrophic failure or underwent revision surgery. These data show low polyethylene wear rates and no catastrophic failures at early followup in a young patient cohort.

Level of Evidence - Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.