Review Article

Recent update on crosslinked polyethylene in total hip arthroplasty

¹ Centre Orthopédique Santy, 24, avenue Paul Santy, 69008 Lyon, France
² Hôpital Privé Jean-Mermoz, 55, avenue Jean-Mermoz, 69008 Lyon, France
³ Département de Chirurgie Orthopédique, Université Paris-Descartes, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France

^* Corresponding author: drjeanlanglois@gmail.com

Received: 22 April 2020
Accepted: 23 April 2020

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.