Cross-linked polyethylene does not reduce wear in total knee arthroplasty

© 2018 SECOT Aim: To compare two different types of inserts: Ultra-high molecular weight polyethylene (UHMWPE) and cross-linked polyethylene with a quantitative and qualitative study of polyethylene wear particles in synovial fluid 3 years after total knee arthroplasty. Material and methods: A prospective, randomized, controlled cohort study with blinded evaluation was carried out on 25 patients undergoing staged bilateral total knee replacement, 6 months apart. Knee arthrocentesis was performed on 12 patients 3 years after surgery, and the polyethylene particles were analyzed. Results: No significant differences were found in the number of particles generated by the two different types of inserts at 3 years from total knee arthroplasty (3,000×: x¯ cross-linked = 849.7; x¯ UHMWPE = 796.9; P =.63; 20,000×: x¯ cross-linked = 66.3; x¯ UHMWPE = 73.1; P =.76). Likewise, no differences in the probability of finding elongated (χ2 = 0.19; P =.66) or rounded (χ2 = 1.44; P =.23) particles in both types of inserts were observed. However, the probability of finding fibrillar particles is 3.08 times greater in UHMWPE. Conclusions: Cross-linked polyethylene does not significantly reduce the generation of polyethylene particles in patients with total knee arthroplasty, 3 years after the surgical procedure.