Minimum 10-Year Outcomes of Total Hip Arthroplasty With Highly Cross-Linked Polyethylene in Patients Under 50 Years: A Systematic Review and Meta-Analysis.
Zachary D Randall, Mitchell S Mologne, Dominic J Gaziano et al.
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In 30 seconds
This systematic review and meta-analysis assessed long-term total hip arthroplasty (THA) outcomes using highly cross-linked polyethylene (HXLPE) in patients under 50 years. It included 18 studies covering 1,587 hips, with a weighted mean follow-up of 14.1 years. Overall revision-free survivorship was 98%, and the weighted mean Harris Hip Score improvement was 43.7 points. The pooled linear wear rate was 0.024 mm/year (95% confidence interval [CI]: 0.013 to 0.035), below the 0.1 mm/year threshold associated with osteolysis risk across reported bearing materials and sizes.
Key findings
- Across 18 studies and 1,587 hips, overall revision-free survivorship was 98%.
- The weighted mean Harris Hip Score improved by 43.7 points.
- Pooled linear wear was 0.024 mm/year (95% CI: 0.013 to 0.035), below the 0.1 mm/year osteolysis-risk threshold.
- Wear rates remained below that threshold regardless of femoral bearing material or size.
Why it matters
Younger patients may live with hip implants for many years, making wear and revision important long-term outcomes. These pooled findings indicate low HXLPE wear and high revision-free survivorship in patients under 50 at extended follow-up. They provide a useful summary of reported long-term outcomes while underscoring that the evidence comes from multiple studies rather than a single controlled comparison.
What to keep in mind
The review included non-randomized studies, and the abstract does not report a direct comparison group; pooled outcomes therefore do not establish comparative treatment effects.