{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T21:21:18Z","timestamp":1793654478138,"version":"4.5.1"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2017,10,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Highly cross-linked polyethylene (XLPE) was developed to address the problem of wear and osteolysis associated with metal-on-conventional ultra-high molecular weight polyethylene (UHMWPE) bearing surfaces. The purpose of this study was to compare in vivo wear rates and clinical and radiographic outcomes between XLPE and UHMWPE in a prospective double-blinded randomized controlled trial with a minimum of 10 years of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We randomized 122 patients to receive either a conventional UHMWPE liner (Enduron; DePuy) or an XLPE liner (Marathon; DePuy). Ninety-one patients were assessed clinically and radiographically at a minimum of 10 years (range, 10.08 to 12.17 years). Oxford Hip Scores and Short Form-12 Health Survey scores were collected. The radiographs were analyzed for osteolysis and for 2-dimensional (2-D), 3-dimensional (3-D), and volumetric wear using validated software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All 122 patients were accounted for at the 10-year follow-up evaluation. Twelve patients had undergone revision surgery, 21 patients had died (1 of whom had previously undergone revision surgery), and 2 patients were unable to return for follow-up, leaving 91 patients available for clinical and radiographic evaluation. At a minimum of 10 years, 3-D wear rates were significantly lower (p &lt; 0.001) in the XLPE group (mean, 0.03 mm\/yr) than in the conventional UHMWPE group (mean, 0.27 mm\/yr). The prevalence of osteolysis was also significantly lower in the XLPE group (38% versus 8%, p &lt; 0.005), as was the revision rate (14.6% versus 1.9%, p = 0.012), with 10 of the 12 revisions being in the Enduron group. There was no significant difference between the clinical scores of the 2 groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>XLPE liners have significantly reduced wear and are associated with a greater implant survival rate at 10 years compared with conventional UHMWPE liners.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level I<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.16.00878","type":"journal-article","created":{"date-parts":[[2017,10,18]],"date-time":"2017-10-18T13:49:46Z","timestamp":1508334586000},"page":"1703-1714","source":"Crossref","is-referenced-by-count":121,"title":["Highly Cross-Linked Polyethylene Reduces Wear and Revision Rates in Total Hip Arthroplasty"],"prefix":"10.2106","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3774-3791","authenticated-orcid":false,"given":"Peter A.","family":"Devane","sequence":"first","affiliation":[{"name":"Wellington Hospital, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Geoffrey","family":"Horne","sequence":"additional","affiliation":[{"name":"Wellington Hospital, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Ashmore","sequence":"additional","affiliation":[{"name":"Great Western Hospital, Swindon, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathon","family":"Mutimer","sequence":"additional","affiliation":[{"name":"Cheltenham General Hospital, Cheltenham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woosung","family":"Kim","sequence":"additional","affiliation":[{"name":"Wellington Hospital, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Stanley","sequence":"additional","affiliation":[{"name":"University of Otago, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"3","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/0883-5403(92)90050-Z","article-title":"Polyethylene debris-induced osteolysis and loosening in uncemented total hip arthroplasty. 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