Highly cross-linked polyethylene is the new ‘gold standard’ bearing material for total hip arthroplasty

Conventional polyethylene is not used much in total hip arthroplasty (THA); it has been supplanted by oxidation-resistant cross-linked polyethylene (≥50 kGy irradiation). However, studies persist that de-emphasize or ignore cross-linked polyethylene. A selective literature review is used briefly to present the early use of conventional polyethylene and its implication in wear particle-induced osteolysis leading to premature revision surgeries. The current situation is established based on Australian registry data and other studies that advocate the use of cross-linked polyethylene in preference to conventional polyethylene. Although some studies suggest caution in using cross-linked polyethylene, overall it is strongly supported. In the author’s opinion, cross-linked polyethylene is the new reference standard bearing material in THA.