Wear Rates With Large Metal and Ceramic Heads on a Second Generation Highly Cross-Linked Polyethylene at Mean 6-Year Follow-Up

Second generation HXLPE had low wear rates and we were unable to detect a significant difference in wear rates with 32- or 36-mm metal and ceramic heads. We believe that this is due to the excellent tribological properties of second generation HXLPE. We continue to use ceramic as standard of care because of issues of trunnionosis with metal heads.