This systematic review and quantitative weighted-averages analysis (391 studies screened, 28 included) examines radiographic wear rates and osteolysis incidence for first-generation highly crosslinked polyethylene (HXLPE) versus conventional UHMWPE in hip arthroplasty, and surveys the available knee arthroplasty literature.
When selecting a bearing for primary THA, HXLPE paired with a standard metallic head (≤32 mm) is supported by robust evidence for dramatically lower wear and osteolysis risk; if you're planning a large-head construct (>32 mm) or a ceramic head, recognize that the wear advantage of HXLPE has not been established for those combinations and counsel patients accordingly.
This systematic review and quantitative weighted-averages analysis (391 studies screened, 28 included) examines radiographic wear rates and osteolysis incidence for first-generation highly crosslinked polyethylene (HXLPE) versus conventional UHMWPE in hip arthroplasty, and surveys the available knee arthroplasty literature.
When selecting a bearing for primary THA, HXLPE paired with a standard metallic head (≤32 mm) is supported by robust evidence for dramatically lower wear and osteolysis risk; if you're planning a large-head construct (>32 mm) or a ceramic head, recognize that the wear advantage of HXLPE has not been established for those combinations and counsel patients accordingly.