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J Am Acad Orthop Surg, Vol 14, No 9, September 2006, 511-523.
© 2006 the American Academy of Orthopaedic Surgeons
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Highly Cross-linked Polyethylene in Total Hip Arthroplasty

Alexander C. Gordon, MD, Darryl D. D’Lima, MD and Clifford W. Colwell, Jr, MD

Dr. Gordon is Orthopaedic Surgeon, Illinois Bone and Joint Institute, Morton Grove, IL. Dr. D’Lima is Director, Orthopaedic Research Laboratories, Scripps Center for Orthopaedic Research and Education, La Jolla, CA. Dr. Colwell is Director, Musculoskeletal Center; Director, Scripps Center for Orthopaedic Research and Education; and Shiley Chair, Orthopaedic Research, Scripps Center for Orthopaedic Research and Education.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Gordon, Dr. D’Lima, and Dr. Colwell.

Reprint requests: Dr. Gordon, Illinois Bone and Joint Institute, 9000 Waukegan Road, Morton Grove, IL 60053.

Although total hip arthroplasty is a common and highly successful procedure, its long-term durability has been undermined by the cellular response to polyethylene wear debris and the subsequent effects on periprosthetic bone. Research elucidating the effects of sterilization on polyethylene wear has facilitated the development of a more wear-resistant material—highly cross-linked polyethylene. Laboratory testing has demonstrated that highly cross-linked polyethylene has markedly improved wear resistance compared with conventional polyethylene under a variety of conditions. Early clinical data have supported these results. To make informed decisions about this already widely available and frequently used product, the practicing orthopaedic surgeon should have a basic understanding of the production process as well as knowledge of the most current laboratory and clinical data.






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