Five-year experience with Crossfire® highly cross-linked polyethylene

Our purpose was to compare the clinical wear performance of highly cross-linked (Crossfire (R)) polyethylene with conventional (N2Vac (TM)) polyethylene total hip bearings. We implanted 56 hips (47 patients) with Crossfire (R) acetabular bearing liners and compared their wear performance with 53 conventional polyethylene inserts. Wear and clinical data were collected retrospectively at a minimum 4-year and average 5-year followup. The linear femoral head penetration rate measured from plain radiographs was 0.055 mm/year +/- 0.022 mm/year for the Crossfire (R) polyethylene and 0.138 mm/year 0.073 mm/year for the control, a reduction of 60% for the Crossfire (R) components. Calculated annual wear was 0.036 mm/year for the Crossfire (R) components and 0.131 mm/year for the controls, a reduction of 72%. Radiographic review at most recent followup showed a reduction in erosive osteolytic lesions of the proximal femur for the Crossfire (R) components compared with controls, also suggesting a reduction in debris release for the Crossfire (R) components. Complications leading to revision were not seen in the Crossfire (R) or control groups. These clinical findings suggest that this particular highly cross-linked polyethylene can provide wear reduction and an alternate bearing surface for active patient populations. Level of Evidence: Therapeutic study, Level III (retrospective comparative study). See the Guidelines for Authors for a complete description of levels of evidence.