Highly Cross-linked Polyethylene in Posterior Stabilized Total Knee Arthroplasty




This article examines whether any new complications were associated with highly cross-linked polyethylene in posterior stabilized total knee arthroplasty (TKA) due to its altered mechanical properties. Average preoperative Knee Society Scores (KSS) were 49.7 and 51.5, with a range of movement (ROM) of 3° to 116°, and average postoperative KSS were 87.7 clinical and 89.7, with ROM of 0° to 123°. Postoperative alignment averaged 3.8° of valgus. There were no cases of polyethylene or post failure. Short-term results of posterior stabilized TKAs using highly cross-linked polyethylene show good functional outcomes with no evidence of loosening or tibial post failure.








  • Highly cross-linked polyethylene with altered mechanics has recently been introduced to total knee arthroplasty.



  • Concern exists regarding the altered properties, in particular with respect to the tibial post in a posterior stabilized design.



  • No new complications in short-term outcomes were noted with this novel material.



Key Points


Introduction: nature of the problem


Total knee arthroplasty (TKA) is an effective, reliable, and durable treatment of end-stage symptomatic arthritis of the knee. However, with conventional polyethylene, mechanical failure consisting of wear, osteolysis, and loosening are the primary source for failure in active patients and at long-term follow-up following some modular TKA systems. Other designs have not shown the same rate of loosening, although osteolysis remains a concern. Newer designs with conventional polyethylene have not yet shown significant wear and osteolysis at early follow-up, but long-term studies do not exist.


The successful introduction of a highly cross-linked polyethylene into total joint arthroplasty began in the hip as a response to excessive wear and osteolysis noted with conventional polyethylene stored in air. Short-term clinical studies by Hodrick and colleagues and Minoda and colleagues recently showed successful outcomes with highly cross-linked polyethylene in a posterior cruciate–retaining TKA design.


This is the first clinical study to examine outcomes with highly cross-linked polyethylene applied to a posterior stabilized design. The polyethylene post provides a further area for concern with the altered mechanical properties of highly cross-linked polyethylene. We sought to determine whether this new substance affects the short-term outcomes of posterior stabilized TKA, and specifically to address the concerns of tibial post failure.

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Feb 23, 2017 | Posted by in ORTHOPEDIC | Comments Off on Highly Cross-linked Polyethylene in Posterior Stabilized Total Knee Arthroplasty

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