Recent update on crosslinked polyethylene in total hip arthroplasty

Abstract

More than two decades after their clinical introduction, crosslinked polyethylenes (XLPE) have been widely adopted. Though concerns were initially raised regarding oxidation and brittleness, on a large scale, the first generation of XLPE continues to be highly effective 15 years after the surgery, even in a young and active population. Remelted XLPE might display lower wear rates than annealed XLPE. Second generation XLPEs, not only including sequentially irradiated and annealed but also associated with antioxidants, demonstrate encouraging short- to mid-term results. Registry data support clinical trial reports. Even in less favorable settings (lipped liners, dual mobility cups, revision surgery, hip resurfacing) results are promising. However, failures (fractures) have already been described. Therefore, a high level of surveillance remains crucial.

Late Breakage of a Dual-Mobility Polyethylene Insert in a Revision Total Hip Arthroplasty: An Unusual Failure Mode

“…[ 27 ], may have been caused by luxation (or reduction) and later evolved into a complete breakage of the polyethylene. The breakage of polyethylene liners in conventional THA is a rare but known complication [ 28 ] that has been related to the progression of fatigue cracks in modern, highly cross-linked polyethylene [ 29 ]. As a notch was present in the removed implant ( Fig.…”

A critical review on ultra high molecular weight polyethylene (UHMWPE) for prosthesis and implant functions

“…UHMWPE is recorded by the international standards organization (ISO) as a polymer having a molecular weight of 1 million gram per mole with degree of polymerization of 36,000. It is a semi-crystalline polymer with fully amorphous and crystalline phases [8]. while the American Society for Testing and Materials (ASTM) states that UHMWPE has a molecular weight of more than 3.1 million g/mole and a degree of polymerization of 110,000.…”

Characterization of shape memory silane cross‐linked low‐density polyethylene prepared by solid‐phase grafting process

“…Due to its low dielectric loss and low conductivity, XLPE is often used as an insulating material for high‐voltage direct current (HVDC) cable 4–6 . Because XLPE shows a lower wear rate than conventional polyethylene, it has been used in clinical medicine as an orthopedic bearing material for many years 7–9 …”

“…[4][5][6] Because XLPE shows a lower wear rate than conventional polyethylene, it has been used in clinical medicine as an orthopedic bearing material for many years. [7][8][9] The cross-linking of polyethylene can be achieved by a variety of methods, some of which have been widely applied in industrial production 10 : the chemical cross-linking method mainly includes the use of peroxide and silane, while the physical cross-linking method is achieved by radiation. 11 Among these methods, silane crosslinking has the advantages of low cost, high efficiency, and easy processing.…”