Comparison of Polyethylene Wear between Highly Crosslinked and Annealed UHMWPE and Conventional UHMWPE against Ceramic Heads in Total Hip Arthroplasty


Article Preview

The purpose of this study was to examine the effects of ceramic femoral head material on the wear of annealed, crosslinked ultra-high molecular weight polyethylene (UHMWPE) (XLPE) in total hip arthroplasty compared to non-crosslinked conventional UHMWPE (CPE). XLPE was fabricated by crosslinking with 60 kGy irradiation and annealing. Femoral heads made from zirconia and alumina ceramics, and cobalt-chrome (CoCr) of 22 mm or 26 mm diameter were used. In this study, the femoral head penetration into the cup was measured digitally on radiographs of 70 hips with XLPE and 50 hips with CPE. The average follow-up periods were 6.1 and 12.7 years, respectively. The steady wear rate of XLPE was significantly lower than those of CPE (0.002 versus 0.08 mm/year, respectively). Zirconia displayed increased wear rates compared to alumina in CPE; however, there was no difference among head materials in XLPE (0.0028, 0.011 and 0.009 mm/year for zirconia, alumina and CoCr, respectively). Neither head size or implantation period impacted XLPE wear. In contrast to CPE, XLPE displayed low wear rates surpassing the effects of varying femoral head material, size, implantation period and patient demographics.



Key Engineering Materials (Volumes 529-530)

Main Theme:

Edited by:

Kunio Ishikawa and Yukihide Iwamoto




T. Sato et al., "Comparison of Polyethylene Wear between Highly Crosslinked and Annealed UHMWPE and Conventional UHMWPE against Ceramic Heads in Total Hip Arthroplasty", Key Engineering Materials, Vols. 529-530, pp. 279-284, 2013

Online since:

November 2012




[1] WH. Harris, The problem is osteolysis. Clin Orthop Relat Res 311 (1995) 46-53.

[2] SB. Goodman, T. Ma, Cellular chemotaxis induced by wear particles from joint replacements, Biomaterials 31 (2010) 5045-5050.


[3] SM. Kurtz, HA. Gawel, JD. Patel, History and systematic review of wear and osteolysis outcomes for first-generation highly crosslinked polyethylene, Clin Orthop Relat Res 469 (2011) 2262-2277.


[4] B. Derbyshire, J. Fisher, D. Dowson et al., Comparative study of the wear of UHMWPE with zirconia ceramic and stainless steel femoral heads in artificial hip joints. Med Eng Phys 16 (1994) 229-236.


[5] JA. Geller, H. Malchau, C. Bragdon et al., Large diameter femoral heads on highly cross-linked polyethylene: Minimum 3-year results. Clin Orthop Relat Res 447 (2006) 53-59.


[6] PF. Lachiewicz, DS. Heckman, ES. Soileau et al., Femoral head size and wear of highly cross-linked polyethylene at 5 to 8 years. Clin Orthop Relat Res 467 (2009) 3290-3296.


[7] HJ. Agins, NW. Alcock, M. Bansal et al., Metallic wear in failed titanium-alloy total hip replacements. A histological and quantitative analysis, J Bone Joint Surg Am 70 (1988) 347-356.


[8] VO. Saikko, PO. Paavolainen, P. Slatis, Wear of the polyethylene acetabular cup. metallic and ceramic heads compared in a hip simulator, Acta Orthop Scand 64 (1993) 391-402.


[9] P. Kumar, M. Oka, K. Ikeuchi et al., Low wear rate of UHMWPE against zirconia ceramic (Y-PSZ) in comparison to alumina ceramic and SUS 316L alloy, J Biomed Mater Res 25 (1991) 813-828.


[10] B. Liang, K. Kawanabe, K. Ise et al., Polyethylene wear against alumina and zirconia heads in cemented total hip arthroplasty, J Arthroplasty 22 (2007) 251-257.


[11] Y. Nakashima, K. Hayashi, T. Inadome et al., Hydroxyapatite-coating on titanium arc sprayed titanium implants. J Biomed Mater Res 35 (1997) 287-298.


[12] RM. d'Aubigne, M. Postel, The classic: Functional results of hip arthroplasty with acrylic prosthesis. 1954. Clin Orthop Relat Res 467 (2009) 7-27.


[13] PA. Devane, JG. Horne, Assessment of polyethylene wear in total hip replacement, Clin Orthop Relat Res 369 (1999) 59-72.

[14] RW. McCalden, SJ. MacDonald, CH. Rorabeck et al., Wear rate of highly cross-linked polyethylene in total hip arthroplasty. A randomized controlled trial, J Bone Joint Surg Am 91 (2009) 773-782.


[15] OK. Muratoglu, CR. Bragdon, DO. O'Connor et al., Unified wear model for highly crosslinked ultra-high molecular weight polyethylenes (UHMWPE), Biomaterials 20 (1999) 1463-1470.


[16] K. Haraguchi, N. Sugano, T. Nishii et al., Phase transformation of a zirconia ceramic head after total hip arthroplasty, J Bone Joint Surg Br 83 (2001) 996-1000.


[17] K. Kawate, T. Ohmura, I. Kawahara et al., Differences in highly cross-linked polyethylene wear between zirconia and cobalt-chromium femoral heads in japanese patients: A prospective, randomized study. J Arthroplasty 24 (2009) 1221-1224.