{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:04:21Z","timestamp":1791320661477,"version":"4.3.1"},"reference-count":80,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4,21]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>This study compared the incidence of osteolysis, aseptic loosening, and revision following use of highly cross-linked polyethylene (HXLPE) or conventional polyethylene (CPE) at medium to long-term (&gt;5 to 15 years) follow-up in primary total hip arthroplasty (THA). Incidences were quantified and compared with regard to age and method of implant fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, 12 randomized controlled trials and 18 cohort studies were investigated for evidence-based outcomes following HXPLE and CPE use in 2,539 hips over a 5 to 15-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Lower rates of osteolysis, aseptic loosening, and implant revision were reported following use of HXLPE liners. Osteolysis was reduced from 25.4% with CPE to 4.05% with HXLPE in young patients, and from 29.7% to 6.6% in the older patient cohort. Similarities in osteolysis rates were observed when cemented (24.9% for CPE and 6.5% for HXLPE) and uncemented components (32.8% for CPE and 7.1% for HXLPE) were compared. No clear advantage in the type of HXLPE used was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Over a follow-up period of up to 15 years, when compared with CPE, use of HXLPE liners reduced the incidence of osteolysis, aseptic loosening, and implant revision, regardless of the fixation method and including in younger and potentially more active patients.<\/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 III<\/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.20.01086","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T09:33:18Z","timestamp":1610530398000},"page":"728-740","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":61,"title":["Incidence of Osteolysis and Aseptic Loosening Following Metal-on-Highly Cross-Linked Polyethylene Hip Arthroplasty"],"prefix":"10.2106","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0046-7079","authenticated-orcid":false,"given":"Hannah","family":"Prock-Gibbs","sequence":"first","affiliation":[{"name":"College of Medicine, University of Central Florida, Orlando, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3886-0703","authenticated-orcid":false,"given":"Cyrus Anthony","family":"Pumilia","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Central Florida, Orlando, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4868-1725","authenticated-orcid":false,"given":"Teerin","family":"Meckmongkol","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Central Florida, Orlando, Florida"},{"name":"Departments of General Surgery (T.M.) and Orthopaedics, Sports Medicine and Physical Medicine and Rehabilitation (J.L.), Nemours Children\u2019s Hospital, Orlando, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2754-0878","authenticated-orcid":false,"given":"John","family":"Lovejoy","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Central Florida, Orlando, Florida"},{"name":"Departments of General Surgery (T.M.) and Orthopaedics, Sports Medicine and Physical Medicine and Rehabilitation (J.L.), Nemours Children\u2019s Hospital, Orlando, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2110-1583","authenticated-orcid":false,"given":"Aadil","family":"Mumith","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Central Florida, Orlando, Florida"},{"name":"Department of Orthopaedics, Basingstoke and North Hampshire Hospital, Basingstoke, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4543-4756","authenticated-orcid":false,"given":"Melanie","family":"Coathup","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Central Florida, Orlando, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,1,7]]},"reference":[{"issue":"3","key":"bib3-20250430","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.cger.2012.06.001","article-title":"Health-related quality of life after total joint arthroplasty: a scoping review","volume":"28","author":"Jones","year":"2012","journal-title":"Clin Geriatr Med."},{"key":"bib4-20250430","first-page":"1120700019896970","article-title":"Wear and osteolysis outcomes for highly cross-linked polyethylene in primary total hip arthroplasty compared with conventional polyethylene: a 15- to 18-year single-centre follow-up study","author":"Moon","year":"2020","journal-title":"Hip Int."},{"issue":"7322","key":"bib5-20250430","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1016\/S0140-6736(63)90759-1","article-title":"Tissue reaction to the polytetraflouroethyene","volume":"282","author":"Charnley","year":"1963","journal-title":"Lancet."},{"issue":"453","key":"bib7-20250430","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/01.blo.0000246547.18187.0b","article-title":"2006 Otto Aufranc Award Paper: significance of in vivo degradation for polyethylene in total hip arthroplasty","volume":"453","author":"Kurtz","year":"2006","journal-title":"Clin Orthop Relat Res."},{"issue":"18","key":"bib8-20250430","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1016\/0142-9612(95)00349-5","article-title":"Gamma sterilization of UHMWPE articular implants: an analysis of the oxidation problem. 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