Total hip replacement is a fantastic operation for those who suffer from hip arthritis. It can relieve pain and restore function better than any other operation. It is also incredibly durable, with over 95 percent of the hips I implanted ten years ago still functioning well. However, these implants can fail and require a second surgery to repair them. The most common cause of failure is wear of the artificial bearing.
Polyethylene is the material that has been used in the past to provide the bearing surface for total hip replacement. When articulated against metal, it is clearly the weakest link and can wear out. Furthermore, the wear particles that are produced can lead to local bone loss and implant loosening. This issue has been under study for nearly 30 years and the subsequent research has been fruitful. Improvements in the material have been made, including better manufacturing and sterilization processes. This has led to the use of highly cross-linked polyethylene in our total hip components. The highly cross-linked material should have better wear resistance and lead to longer lasting total hip components. This may improve the service life of the artificial hip to 30 years or more. This material is now used routinely in my practice.