Hip implants containing crossed-linked polyethylene (XLPE) significantly reduce the risk of a patient requiring correction surgery post a total hip replacement, concluded an Australian long-term follow-up study.

The study, published in The Journal of Bone & Joint Surgery was led by Australian Orthopaedic Association National Joint Replacement Registry professor Richard de Steiger. He and his colleagues wrote: “The use of XLPE has resulted in a significant reduction in the rate of revision at 16 years following total hip arthroplasty for osteoarthritis.”

The new XLPE implants could make total hip replacement more feasible for younger patients due to its longer durability compared to Implants containing conventional polyethylene (CPE) components.

An estimated 240,000 patients with hip osteoarthritis who underwent total hip replacement in Australia between 1999 and 2016 were registered for the study.

Revision rates were remarkably lower in patients with XLPE bearings, as early as six months post the surgery. During 16 years, the cumulative rate of revision surgery was 11.7% in the CPE cluster contrasted to 6.2% in the XPLE cluster.

After considering other risk factors, patients with CPE implants were approximately three times more likely to undergo revision surgery after nine years. Wear of the bearing surface revisions developed in 0.81% of procedures with CPE and 0.05% of procedures with XLPE.

Seven years after surgery, younger patients with CPE hip implants were around five times more likely to need correction surgery.

De Steiger and his colleagues concluded: “Wear-related and implant-longevity issues are particularly important in younger patients, who are generally more active and have a longer lifespan than their older counterparts.

“We believe that the evidence of reduced long-term wear with XLPE is now so strong that, when a polyethylene bearing surface is used in THA, it should be XLPE, particularly in younger patients.”