Highly Cross-linked Polyethylene–Metal Articulations as an Alternative to Ceramic on Ceramic for Total Hip Replacement Surgery

The excellent in vivo human wear data out to 5.5 years using highly cross-linked polyethylene against metal heads in total hip arthroplasty matches the data for ceramic-on-ceramic wear. The melted polyethylene does not oxidize. Large heads can be used. Therefore, decisions regarding the choice of this couple versus a ceramic couple reside in other issues. In all five categories of these other issues, namely familiarity, forgiveness, adaptability, absence of specific disadvantages of ceramic-on-ceramic, and cost, polyethylene appears to have important advantages.