Conclusion Total hip arthroplasty in patients younger than 55 years provides reliable outcomes at up to 10 years .
Background Total hip arthroplasty ( THA ) is increasingly performed in younger patients despite the lack of comprehensive assessment of long-term outcomes .
We systematic ally review ed the contemporary literature to assess the 1 ) indications , 2 ) implant selection and long-term survivorship , 3 ) complication and reoperation rates and 4 ) radiographic and functional outcomes of primary THA in patients younger than 55 years .
The John Charnley Award: Highly Crosslinked Polyethylene in Total Hip Arthroplasty Decreases Long-term Wear: A Double-blind Randomized Trial
Background The use of highly crosslinked polyethylene ( HXLPE ) is now commonplace for total hip arthroplasty . Hip simulator studies and short-term in vivo measurements suggest that the wear rate of some types of HXLPE is significantly less than conventional ultrahigh-molecular-weight polyethylene ( UHMWPE ) . However , there are few long-term data to support its use . Questions / purpose sThe aim of this study was to measure the long-term steady-state wear of HXLPE compared with UHMWPE liners in a prospect i ve , double-blind , r and omized controlled trial using radiostereometric analysis . Methods Fifty-four patients were r and omized to receive hip arthroplasties with either UHMWPE liners or HXLPE liners .  Complete followup was available on 39 of these patients ( 72 % ) . All patients received the same cemented stem and an uncemented acetabular component . Three-dimensional penetration of the head into the socket was determined at 10 years using a radiostereometric analysis system , which has an in vivo accuracy of < 0.1 mm . Oxford Hip Scores were compared between the groups . Results At 10 years there was significantly less wear of HXLPE ( 0.003 mm/year ; 95 % confidence interval [ CI ] , ± 0.010 ; SD 0.023 ; range , −0.057 to 0.074 ) compared with UHMWPE ( 0.030 mm/year ; 95 % CI , ± 0.012 ; p < 0.001 ; SD 0.0.27 ; range , −0.001 to 0.164 ) . The volumetric penetration from 1 to 10 years for the UHMWPE group was 98 mm3 ( 95 % CI , ± 46 mm3 ; SD 102 mm3 ; range , −4 to 430 mm3 ) compared with 14 mm3 ( 95 % CI , ± 40 mm3 ; SD 91 mm3 ; range , −189 to 242 mm3 ) for the HXLPE group ( p = 0.01 ) . Conclusions This study demonstrates that HXLPE has little detectable steady-state in vivo wear . This may result in fewer reoperations from loosening ; however , careful clinical followup into the second decade still needs to be performed . Level of Evidence Level I , therapeutic study . See the Guidelines for Authors for a complete description of levels of evidence
Conclusion Total hip arthroplasty in patients younger than 55 years provides reliable outcomes at up to 10 years .
Background Total hip arthroplasty ( THA ) is increasingly performed in younger patients despite the lack of comprehensive assessment of long-term outcomes .
We systematic ally review ed the contemporary literature to assess the 1 ) indications , 2 ) implant selection and long-term survivorship , 3 ) complication and reoperation rates and 4 ) radiographic and functional outcomes of primary THA in patients younger than 55 years .