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Introduction <p>This study investigated 20-year outcomes of total hip arthroplasty (THA) using zirconia heads on annealed highly cross-linked polyethylene (HXLPE) liners, comparing patients aged ≤ 50 and &gt; 50.</p> Methods <p>We reviewed 117 hips (100 patients) who underwent cementless THA between 2001 and 2004. After excluding follow-up &lt; 15 years, 22 hips (≤ 50) and 61 hips (&gt; 50) were analyzed. Merle d’Aubigné and Postel score, University of California, Los Angeles activity score, Kaplan–Meier survivorship, femoral head penetration, and oxidative degradation in retrieved liners were evaluated.</p> Results <p>Patients ≤ 50 had higher activity. Three revisions for infection occurred in the &gt; 50 group; none due to wear. Survivorship was 93% overall, 100% in ≤ 50, and 91% in &gt; 50, with no difference. Steady-state wear rate was 0.01&#xa0;mm/year in both groups. Retrieved liners showed oxidation.</p> Conclusion <p>Zirconia-on-annealed HXLPE THA showed excellent 20-year wear resistance and survivorship, with comparable outcomes between ≤ 50 and &gt; 50 groups.</p>

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Comparison of 20-year results of total hip arthroplasty using first-generation annealed highly cross-linked polyethylene and zirconia heads in patients aged ≤ 50 and > 50 years

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月17日

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  • Yohei Naito,
  • Shine Tone,
  • Gai Kobayashi,
  • Masahiro Hasegawa

摘要

Introduction

This study investigated 20-year outcomes of total hip arthroplasty (THA) using zirconia heads on annealed highly cross-linked polyethylene (HXLPE) liners, comparing patients aged ≤ 50 and > 50.

Methods

We reviewed 117 hips (100 patients) who underwent cementless THA between 2001 and 2004. After excluding follow-up < 15 years, 22 hips (≤ 50) and 61 hips (> 50) were analyzed. Merle d’Aubigné and Postel score, University of California, Los Angeles activity score, Kaplan–Meier survivorship, femoral head penetration, and oxidative degradation in retrieved liners were evaluated.

Results

Patients ≤ 50 had higher activity. Three revisions for infection occurred in the > 50 group; none due to wear. Survivorship was 93% overall, 100% in ≤ 50, and 91% in > 50, with no difference. Steady-state wear rate was 0.01 mm/year in both groups. Retrieved liners showed oxidation.

Conclusion

Zirconia-on-annealed HXLPE THA showed excellent 20-year wear resistance and survivorship, with comparable outcomes between ≤ 50 and > 50 groups.