Wear of a sequentially annealed polyethylene acetabular liner

Acta Orthop. 2014 Sep;85(5):470-3. doi: 10.3109/17453674.2014.949044. Epub 2014 Aug 20.


Background and purpose: We previously reported on a randomized controlled trial (RCT) that examined the effect of adding tobramycin to bone cement after femoral stem migration. The present study examined femoral head penetration into both conventional and highly crosslinked polyethylene acetabular liners in the same group of RCT patients, with a minimum of 5 years of postoperative follow-up.

Patients and methods: Linear penetration of the femoral head into an X3 (Stryker) crosslinked polyethylene (XLPE) liner was measured in 18 patients (19 hips) using radiostereometric analysis (RSA). Femoral head penetration was also measured in 6 patients (6 hips) with a conventional polyethylene liner (CPE), which served as a control group.

Results: The median proximal femoral head penetration in the XLPE group after 5.5 years was 0.025 mm with a steady-state penetration rate of 0.001 mm/year between year 1 and year 5. The CPE liner showed a median proximal head penetration of 0.274 mm after 7.2 years, at a rate of 0.037 mm/year.

Interpretation: The Trident X3 sequentially annealed XLPE liner shows excellent in vivo wear resistance compared to non-crosslinked CPE liners at medium-term implantation. The rate of linear head penetration in the XLPE liners after > 5 years of follow-up was 0.001 mm/year, which is in close agreement with the results of previous studies.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acetabulum / pathology
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / methods
  • Bone Cements / adverse effects
  • Bone Cements / therapeutic use*
  • Female
  • Femur Head / pathology
  • Humans
  • Male
  • Middle Aged
  • Polyethylene*
  • Prosthesis Failure*
  • Radiostereometric Analysis


  • Bone Cements
  • Polyethylene