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Early Failure Due to Osteolysis Associated with Contemporary Highly Cross-Linked Ultra-High Molecular Weight PolyethyleneA Case Report
Letitia Bradford, MD1; Robert Kurland, MD2; Meera Sankaran, BS3; Hubert Kim, MD, PhD1; Lisa A. Pruitt, PhD3; Michael D. Ries, MD1
1 Department of Orthopaedic Surgery, University of California at San Francisco, 500 Parnassus Avenue, MU-320 West, San Francisco, CA 94143. E-mail address for L. Bradford: letitiabradford@yahoo.com
2 Department of Orthopedic Surgery, Olmsted Medical Center, 210-9th Street S.E., Rochester, MN 55904-6425
3 Department of Mechanical Engineering-Bioengineering, University of California at Berkeley, 2121 Etcheverry Hall, Berkeley, CA 94720
View Disclosures and Other Information
The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at the Department of Mechanical Engineering-Bioengineering, University of California at Berkeley, Berkeley, California

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2004 May 01;86(5):1051-1056
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Extract

Cross-linking changes the wear and mechanical behavior of ultra-high molecular weight polyethylene. Contemporary highly cross-linked ultra-high molecular weight polyethylene has demonstrated markedly improved wear in vitro and a reduction in static and fatigue strength compared with conventional ultra-high molecular weight polyethylene1-7.Studies employing hip simulators have shown a reduction in the volume of wear debris generated with cross-linked polyethylene in comparison with that generated with conventional polyethylene8. However, the average size of wear particles also appeared to be reduced, which means that the actual number of generated particles may not be decreased8. The osteolytic response to particulate debris is variable and may depend more on a number of factors, including the number and the size of particles, than on the total volume of debris generated9,10. The long-term clinical results of the use of currently available contemporary highly cross-linked ultra-high molecular weight polyethylene components in total hip arthroplasty are not yet known.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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