Highly cross-linked polyethylene can reduce wear rate in THA for high demand patients: a matched-paired controlled study

Abstract Background The average age of patients benefiting from Total Hip Arthroplasty (THA) has been declining. In addition to pain relief, patients seek to return to physical activity. However, the latter may increase polyethylene wear, and therefore the potential risk of early aseptic loosening. The introduction of Highly Cross-linked Polyethylene (HXLPE) has reduced wear rates in the general patient population. The objective of this study was to evaluate the influence of impact sports in patients operated with THA using ceramic-on-conventional polyethylene (cPE) versus ceramic-on-HXLPE, in terms of wear and function, with a minimum of five years follow-up. Methods Sixty-eight patients practicing an impact sport (UCLA ≥ 8) that underwent a primary THA were included: 34 with a ceramic-on-cPE versus 34 with a ceramic-on-HXLPE using the same cementless acetabular and femoral component. Patients were matched-paired by age, sex, BMI and UCLA score. The wear analysis was performed using the IMAGIKA® software. The Harris Hip Score (HHS) and Hip and Osteoarthritis Outcome Score (HOOS) were collected. Results The linear wear rate was statistically higher (P Conclusion Patients partaking in impact sports and receiving a ceramic-on-HXLPE THA demonstrated lower wear and osteolysis rates than those having a ceramic-on-cPE THA, with similar functional results.