Cross-Linked Implants Reduce Revision Surgery Rates

XLPE implants were associated with a lower rate of revision at six months, with the difference becoming more apparent over time. The 16-year cumulative percentage of revisions of primary THAs was 11.7% in the CPE group and 6.2% in the XLPE group.

After adjustment for other risk factors, patients with CPE implants were about three times more likely to have revision surgery after nine years, compared to those with XLPE implants. At seven years, younger patients with CPE hip prostheses were about five times more likely to need revision surgery. Revisions directly related to wear of the bearing surface occurred in 0.81% of procedures that used CPE, compared to just 0.05% of procedures that used XLPE. The study was published on August 1, 2018, in The Journal of Bone & Joint Surgery.

“Wear-related and implant-longevity issues are particularly important in younger patients, who are generally more active and have a longer life span than their older counterparts,” concluded Professor Richard de Steiger, MD, of SAHMRI, and colleagues. “We believe that the evidence of reduced long-term wear with XLPE is now so strong that, when a polyethylene bearing surface is used in THA, it should be XLPE, particularly in younger patients."

THA is one of the most effective surgical procedures for the management of hip OA. The most common bearing surface for THA has been conventional CPE, which has been in use for over 50 years. As limiting wear of the bearing surface is critical to long-term success, particularly for younger patients, research has led to the development of XLPE, which has improved wear characteristics.

Related Links:
South Australian Health and Medical Research Institute
University of Adelaide
Australian Orthopaedic Association