Abstract
In 1998, lysis / wear were the biggest concerns in THR. 3 distinct tacks emerged: Alternatives to polyethylene: Ceramic / Ceramic; Metal / Metal; Make a better polyethylene
MOM story is well known: bad ending!!
Large adoption of Ceramic / Ceramic: positives: low wear, benign MR findings, even low dislocation rates !! negatives: fractures still occurred, noise generation, liner malseating, metal transfer (edge effects)
Crosslinked Polyethylene: Update: 13–15 year follow-up of 1st generation XLPE with remelted product: Annual wear rates of 0.004 (metal heads) 0.002 (ceramic heads)!
No lysis!! Wear rates for “standard” heads and large heads both low approaching the lower limits of detection!!
CONCLUSION: Crosslinked Polyethylene with Ceramic Heads: The Winner and Still Champion!
