2024 AAHKS Annual Meeting: Multicenter Randomized Clinical Trial of HXLPE vs. Conventional PE in 500 Primary TKAs at 10 Years

Five hundred eighteen patients undergoing primary total knee arthroplasty were randomized to receive highly cross-linked polyethylene (HXLPE) tibial inserts (n=264) or conventional ultra-high-molecular-weight polyethylene (UHMWPE) tibial inserts (n=254). The primary outcome of interest was implant survivorship free from revision or reoperation. Secondary outcomes included revision indications, radiographic results, and clinical outcomes. Outcomes were assessed over a mean follow-up period of 11 years. Overall, the results revealed no significant differences between groups in revision or reoperation rates, with 10-year survivorships of 96% (HXLPE) and 94% (UHMWPE). Notably, no wear-related failures or fractures occurred in the HXLPE group, while one case of osteolysis occurred in the UHMWPE group. These findings suggest equivalent long-term performance of HXLPE and UHMWPE in primary TKAs, with potentially lower wear-related risks for HXLPE.