Speaker: Osteolysis should still be considered for highly XLPE THA
WAIKOLOA, Hawaii — Late osteolysis may still be a concern for patients undergoing total hip arthroplasty with highly crosslinked polyethylene, despite notable reductions in wear and improved survivorship, a speaker said.
“Highly crosslinked polyethylene (HXLPE) is relatively insensitive to head size, which allowed us to go from 22-mm, 26-mm and 28-mm heads to 36-mm and 40-mm heads, which were associated with high volumetric wear with conventional polyethylene but low rates with HXLPE,” William J. Maloney, MD, said in his presentation at Orthopedics Today Hawaii.
Maloney cited various studies that reported on the benefits of HXLPE, including reductions in head penetration, volumetric and adjusted wear, revision and survivorship. However, late osteolysis is prevalent in a small percentage of cases, he said.
According to Maloney, late osteolysis can ultimately lead to adverse local tissue reaction, secondary to taper corrosion or metal-on-metal articulations, infection, cancer and polyethylene wear. Maloney also revealed a case of osteolysis in an asymptomatic 64-year-old man at 15-year follow-up.
“So far HXLPE has not been an issue, but we are out to now 20 years with these patients. Between 20 and 30 [years], are we going to run into a problem?” Maloney concluded. “I don’t think so. It’s not going to a big problem, but you never know.”
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Maloney WJ. Late osteolysis with XLPE: Who and why. Presented at: Orthopedics Today Hawaii. Jan. 9-13, 2022; Waikoloa, Hawaii.
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