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5 YEAR RESULTS OF A DOUBLE BLINDED, PROSPECTIVE, RANDOMISED TRIAL COMPARING CONVENTIONAL AND HIGHLY CROSS LINKED POLYETHYLENE IN PRIMARY TOTAL HIP ARTHROPLASTY



Abstract

Polyethylene wear and osteolysis continue to be associated with failure of total hip arthroplasty. The advent of highly cross linked polyethylene may potentially reduce such wear.

The aim of this study was to compare the rate of wear of acetabular polyethylene using conventional cross linked versus highly cross linked polyethylene.

From June 2001 to September 2003, 119 patients were followed prospectively for up to five years on an annual basis in a double blinded, randomised trial. The mean age of patients was 59 years (range 48 to 75 yrs). The radiographs have been analyzed using previously validated measurement software to assess linear, three dimensional and volumetric wear.

The five year results show significantly reduced wear rates for highly cross linked polyethylene compared to conventional polyethylene. There was no statistically significant difference between groups with respect to age, sex, operative side, surgeon, cup abduction angle, cup anteversion or size of cup.

The reduction in wear shown after five years with the highly cross linked polyethylene is highly encouraging and is consistent with in vitro wear simulator testing. This may reduce failure of total hip arthroplasties due to wear and osteolysis over the medium to long term.

Correspondence should be addressed to Associate Professor N. Susan Stott, Orthopaedic Department, Starship Children’s Hospital, Private Bag 92024, Auckland, New Zealand.