HXLPE Liners in THA: Less wear but no detectable clinical impact .

Highly cross-linked polyethylene liners in hip arthroplasty showed clear reductions in wear rate and femoral head penetration, yet these mechanical gains did not translate into meaningful clinical advantages. Across trials, patient-reported outcomes, osteolysis rates, and revision surgery showed no measurable differences compared with standard polyethylene. Evidence quality for all outcomes remained low or very low due to bias concerns and inconsistent findings, limiting confidence in the observed effects. While reduced wear may suggest theoretical long-term benefit, current data have not demonstrated clinically important improvements, highlighting the need for more robust, longer-term studies.