Polyethylene (PE) is most commonly used material for the cup of a hip replacement. It’s been used since Sir John Charnley developed the first hip replacements in the 1960s. One of the problems with PE is that as it wears, it produces debris which is taken up by bone cells. This can cause softening of the bone and loosening of the components of the the artificial hip. Engineers found that by irradiating PE, it made it less likely to wear out, and a recent study from Australia has confirmed that it lasts longer. Irradiation causes the PE to develop cross-links (XLPE) between the molecules, making it tougher. I’ve used this type of PE for many years in most of my patients, and it’s good to know that it works so well.

Here’s what the authors said:

‘This new study of hip replacement outcomes in patients with XLPE prostheses provides the longest follow-up in the largest series of patients reported to date. The results provide important “real world” evidence that the reduced wear of XLPE bearings translates in a lower risk of revision surgery. The use of XLPE makes total hip arthroplasty – already one of the most effective operations – even better. Wear-related and implant-longevity issues are particularly important in younger patients, who are generally more active and have a longer life span than their older counterparts,” Prof. de Steiger and colleagues conclude. “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.’

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