Application of highly cross-linked polyethylene (HXLPE) to a posterior cruciate-substituting total knee arthroplasty (TKA) might add the risk of fracture and failure of the tibial polyethylene insert. The purpose of this study is to evaluate the long-term (up to 19 years) clinical and radiographic results of posterior cruciate-substituting TKAs with HXLPE or conventional polyethylene. This study analyzed the results of 1,217 patients (444 men and 773 women; mean age of 65 ± 7 years, range, 31-85) (2,434 knees) who had received a NexGen LPS-Flex prosthesis with a conventional tibial insert in one knee and the same prosthesis with an HXLPE tibial insert in the contralateral knee. The mean duration of follow-up was 17 years (range, 15-19). The 2 groups did not differ significantly ( > .05) with regard to the clinical and radiographic results. No knee in either group had a fracture of the tibial polyethylene post or failure of the locking mechanism of the tibial polyethylene insert or osteolysis. Twenty-eight knees (2.3%) in the HXLPE group and 26 knees (2.1%) in the conventional polyethylene group were revised. The estimated survival rate at 17 years was 97.7% in the HXLPE group and 97.9% in the conventional polyethylene group. The data suggest that clinical and radiographic findings at a mean of 17 years after posterior cruciate-substituting TKA are the same for patients treated with HXLPE and those treated with conventional polyethylene.

中文翻译：

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高度交联聚乙烯用于高屈曲后稳定全膝关节置换术是否安全？

将高度交联聚乙烯 (HXLPE) 应用到后十字形替代全膝关节置换术 (TKA) 中可能会增加胫骨聚乙烯插入物断裂和失效的风险。本研究的目的是评估用 HXLPE 或传统聚乙烯替代后交叉椎全膝关节置换术的长期（长达 19 年）临床和放射学结果。本研究分析了 1,217 名患者（444 名男性和 773 名女性；平均年龄为 65 ± 7 岁，范围为 31-85）（2,434 个膝盖）的结果，这些患者在一个膝盖上接受了带有传统胫骨插入物的 NexGen LPS-Flex 假体以及在对侧膝关节中带有 HXLPE 胫骨插入物的相同假体。平均随访时间为 17 年（范围 15-19 年）。两组在临床和放射学结果方面没有显着差异 (> .05)。两组中均未出现胫骨聚乙烯柱骨折、胫骨聚乙烯插入物锁定机制失效或骨溶解的情况。 HXLPE 组有 28 个膝关节 (2.3%) 进行了修正，传统聚乙烯组有 26 个膝关节 (2.1%) 进行了修正。 HXLPE 组 17 年估计生存率为 97.7%，传统聚乙烯组为 97.9%。数据表明，接受 HXLPE 治疗的患者和接受传统聚乙烯治疗的患者在后交叉韧带替代 TKA 后平均 17 年的临床和影像学结果是相同的。