Twenty-Year Wear Progression and Long-Term Outcomes of Conventional Polyethylene Liners After Cementless Total Hip Arthroplasty
- 1Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
- 2Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan; Corresponding author. 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Tel.: +813 3815 5411.
- 3Department of Orthopaedic Surgery, NTT Medical Center Tokyo, Tokyo, Japan
Abstract
Background: Polyethylene (PE) wear debris can cause periprosthetic osteolysis and late failure after total hip arthroplasty, but long-term wear behavior of conventional non–cross-linked PE remains unclear. Methods: We reviewed 85 consecutive cementless total hip arthroplasties performed between 2002 and 2005 using ArCom non–cross-linked PE liners (Biomet Inc., Warsaw, IN). After excluding 31 hips lost to follow-up and 5 revised hips, 49 hips (45 patients) with ≥20 years of follow-up were analyzed. Femoral head penetration was measured using PolyWare (Draftware Inc., Vevay, IN) by three independent observers. The first postoperative year was defined as the bedding-in phase, and subsequent penetration as the steady-state phase (SSP). Associations between wear and patient, implant, surgical, and clinical factors were assessed. Results: The mean Japanese Orthopaedic Association score improved from 39.6 ± 10.6 preoperatively to 84.4 ± 12.9 at 20 years ( P < .001). Osteolysis was observed in 18 hips. Mean bedding-in phase and SSP wear rates were 0.235 ± 0.155 mm/y and 0.031 ± 0.023 mm/y, respectively. SSP wear correlated linearly with postoperative time (R 2 = 0.99). Hips with higher SSP wear (>0.025 mm/y) had higher 20-year Japanese Orthopaedic Association gait ( P = .033), activities of daily living ( P = .018), and total scores ( P = .013). Charnley category A had higher SSP wear than category B ( P = .024), whereas osteolysis did not affect wear rates. Conclusions: ArCom conventional PE showed a nearly constant SSP wear rate over 20 years. Exploratory analyses suggested associations with functional status and Charnley category, but not with other patient, implant, or surgical factors.
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BibTeX
@article{yasutakawatanabe2026twentyyear,
title = {{Twenty-Year Wear Progression and Long-Term Outcomes of Conventional Polyethylene Liners After Cementless Total Hip Arthroplasty}},
author = {Yasutaka Watanabe, MD and Toru Moro, MD, PhD and Hisatoshi Ishikura, MD, PhD and Hirofumi Oshima, MD and Takeyuki Tanaka, MD, PhD and Sakae Tanaka, MD, PhD},
journal = {Arthroplasty Today},
year = {2026},
month = oct,
doi = {10.1016/j.artd.2026.102187},
url = {https://doi.org/10.1016/j.artd.2026.102187},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Twenty-Year Wear Progression and Long-Term Outcomes of Conventional Polyethylene Liners After Cementless Total Hip Arthroplasty
AU - Yasutaka Watanabe, MD
AU - Toru Moro, MD, PhD
AU - Hisatoshi Ishikura, MD, PhD
AU - Hirofumi Oshima, MD
AU - Takeyuki Tanaka, MD, PhD
AU - Sakae Tanaka, MD, PhD
PY - 2026
DA - 2026/10/22
JO - Arthroplasty Today
DO - 10.1016/j.artd.2026.102187
UR - https://doi.org/10.1016/j.artd.2026.102187
AB - Background: Polyethylene (PE) wear debris can cause periprosthetic osteolysis and late failure after total hip arthroplasty, but long-term wear behavior of conventional non–cross-linked PE remains unclear. Methods: We reviewed 85 consecutive cementless total hip arthroplasties performed between 2002 and 2005 using ArCom non–cross-linked PE liners (Biomet Inc., Warsaw, IN). After excluding 31 hips lost to follow-up and 5 revised hips, 49 hips (45 patients) with ≥20 years of follow-up were analyzed. Femoral head penetration was measured using PolyWare (Draftware Inc., Vevay, IN) by three independent observers. The first postoperative year was defined as the bedding-in phase, and subsequent penetration as the steady-state phase (SSP). Associations between wear and patient, implant, surgical, and clinical factors were assessed. Results: The mean Japanese Orthopaedic Association score improved from 39.6 ± 10.6 preoperatively to 84.4 ± 12.9 at 20 years ( P < .001). Osteolysis was observed in 18 hips. Mean bedding-in phase and SSP wear rates were 0.235 ± 0.155 mm/y and 0.031 ± 0.023 mm/y, respectively. SSP wear correlated linearly with postoperative time (R 2 = 0.99). Hips with higher SSP wear (>0.025 mm/y) had higher 20-year Japanese Orthopaedic Association gait ( P = .033), activities of daily living ( P = .018), and total scores ( P = .013). Charnley category A had higher SSP wear than category B ( P = .024), whereas osteolysis did not affect wear rates. Conclusions: ArCom conventional PE showed a nearly constant SSP wear rate over 20 years. Exploratory analyses suggested associations with functional status and Charnley category, but not with other patient, implant, or surgical factors.
SN - 2352-3441
ER -