A study issued in the 'The Journal of Bone and Joint Surgery' showed that the use of  cross-linked polyethylene was linked to a considerable decrease in the rate of revision at 16 years after total hip arthroplasty.

Total hip arthroplasty (THA) is a useful operation for the end-stage hip osteoarthritis management, but its long-term success can be restricted by wear of the polyethylene bearing surface. In laboratory and clinical studies, the cross-linking conventional polyethylene has lead to the lower wear rates and reduction in bone lysis. This study was executed to distinguish between the rates of revision between cross-linked polyethylene (XLPE) and conventional non-cross-linked polyethylene (CPE) at 16 years after THAs conducted for the treatment of osteoarthritis.

The data for this observational study was taken from a national registry. Patients who underwent THA for OA from 1999 till December 31, 2016 in Australia were included. The results of  THAs performed with CPE were compared with those of THAs performed with XLPE. The effect of sex, age, the technique of femoral and acetabular fixation, size of femoral head, types of revision and reasons for revision were examined to meet the study objectives. The Kaplan-Meier estimates of survivorship were used to reveal the principal  outcome measure (time to the first revision). 

CPE and XLPE were used in 41,171 and 199,131 procedures. The mean age of the men and women treated with CPE were 70.0 years (standard deviation [SD] = 9.9 years) and 72.5 years (SD = 9.7 years). Men and women who obtained XLPE were slightly younger (mean age, 68.6 years [SD = 10.3 years] and 70.7 years [SD = 9.9 years], respectively. As compared to CPE, XLPE was found to be linked to the lower rate of revision at 6 months. Also, the difference increased with the passing time. The 16-year cumulative percentage of revisions of the primary THAs was 11.7% (95% confidence interval [CI] = 11.1% to 12.3%]) and 6.2% (95% CI = 5.7% to 6.7%) in the CPE group and  XLPE group. At 9 years, the hazard ratio was 3.02 (p = 0.001).