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H ip surgeons and material scientists agree that while reducing bearing-surface wear after THA is important, the real goals are to prevent osteolysis and aseptic loosening. Most hip replacements are performed using highly crosslinked polyethylene (XLPE) liners, since many surgeons are concerned about problems associated with ceramic-on-ceramic and metalon-metal (MoM) bearings, including squeaking and ceramic fractures for the former [1], and elevated serum ion levels from (MoM) couplings with the latter [6]. However, although a metaanalysis of randomized trials confirmed that XLPE decreased linear and volumetric wear rates [11], it remains unclear whether XLPE actually reduces the likelihood of aseptic loosening after THA [10]. Recommended as an alternative bearing surface, oxidized zirconium was developed to reduce the wear rates of cobalt-chrome heads against polyethylene bearings. The linear wear rate for oxidized zirconium with XLPE liners has been shown to be 4 lm/year [4]. However, in a 5-year followup of a randomized controlled trial, no difference in wear rates was noted between cobalt-chrome and oxidized zirconium heads with XLPE [9]. Crosslinked polyethylene liners seem to make a larger difference in wear than does the head surface against which the polyethylene is placed.

CORR Insights®: Oxidized Zirconium Head on Crosslinked Polyethylene Liner in Total Hip Arthroplasty: A 7- to 12-year In Vivo Comparative Wear Study