The linear penetration of highly cross-linked polyethylene in isolated cemented liner exchange in Revision Total Hip Arthroplasty

Abstract

Introduction: This study aimed to examine the linear penetration rate of highly cross-linked polyethylene (HXLPE) after isolated liner exchange using cement as a locking mechanism in revision total hip arthroplasty (THA). Methods: A total of 39 THAs in 34 patients (19 men, 15 women) received liner and hip ball exchange due to conventional PE wear. The exchanged liners were marathon HXLPE (DePuy, US) and cemented into the original metal socket. All hip balls were 28 mm in diameter. Annual X-rays were measured for linear penetration and osteolysis. Results: The mean (± standard deviation) age was 60 ± 12.5 years at revision THA. The mean time interval between the primary and revision THA was 12.8 ± 3.1 years. The mean follow-up time after revision was 8.2 ± 2.7 years. The acetabular components included 17 anatomic medullary locking (AML) acetabular cup system, 2 AML Duraloc, 7 Asian hip, and 13 porous-coated anatomic sockets. The mean creep of HXLPE occurred in the first year was 0.43 ± 0.4 mm. The mean annual linear penetration rate from second year onwards was 0.09 ± 0.22 mm/year. All THAs with HXLPE revision showed no osteolysis at last follow-up. Conclusion: Cementing an HXLPE liner into the old metal socket is a safe procedure in revision THA. The HXLPE liner showed satisfactory liner penetration rate after isolated liner exchange procedures.