hy 32-mm Ceramic Heads are the Secret to Lower Penetration Rates

A data-driven look at why surgeons should consider pairing sequentially annealed HXLPE exclusively with 32-mm ceramic femoral heads.

Historically, long-term success in total hip arthroplasty (THA) has been limited by implant loosening and late failure caused by osteolysis at the bone-implant interface due to third-body wear particles of conventional polyethylene. The historical critical threshold for osteolysis in conventional polyethylene is approximately 0.1 mm/y. Over the past 2 decades, advancements in polyethylene cross-linking and sterilization methods have made it possible to irradiate and remelt highly cross-linked polyethylene (HXLPE), which has shown improved tribological properties in biomechanical testing compared to conventional polyethylene, along with encouraging early and mid-term clinical results.

Recently, a sequential annealing process for HXLPE has been introduced with promising tribological and early clinical results compared to irradiated and remelted HXLPE. Few studies to date have reported the effects of femoral head material, femoral head size, and implant position on wear, creep, and head penetration rates for this sequentially annealed HXLPE. We set out to investigate the true mid-term wear rates of this specific material.