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New Hip Replacent Material (highly cross-linked polyethylene)

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dkadlec

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I have very little information on this material and would like to know more before deciding between ceramic or highly cross-linked polyethylene. I am a somewhat athletic 35 year old with arthritis and have to get both hips replaced eventually but I have a lot of questions regarding the newer material.

Has any one heard anything about the newer material referred to as a highly cross-linked polyethylene?

According to my surgeon, ceramic has a potential for cracking and can be dislocated fairly easily.

The highly cross-linked polyethylene can be inserted with a larger ball socket to prevent dislocations, however, the polyethylene has not been tested for very long, that I am aware of.

If anyone has anymore information on either ceramic and/or polyethylene, please let me know.

Thanks,

David
 
Hello David, I am 42 and need both hip replaced. I have an appointment this monday (22nd May) for a second opinion. I will ask the surgeon about this highly cross-linked polyethylene and see what he thinks of it. The first surgeon that i saw said that ceramic on ceramic will be used for me. I trust the doctor that he will make the best choice for me and hopefully it will last me a very long time without problems until the time comes for a revision. When i searched on the internet for each type of artificial hips i came to a conclusion that ceramic on ceramic is the best for my age because it has very low wear and tear, and has been perfectioned to be harder (less breakage) and last 20 to 25 years and maybe more if look after it. Without telling the doctor about my findings on the internet, he suggested himself that ceramic on ceramic would be used if i go ahead with the surgery. So i was not so wrong afterall. Lets see what this second opinion think and keep posted. best wishes, Sonia S.
 
Hello David, I saw the surgeon today and asked him about this highly cross-linked polyethylene and he said that he uses that one for people over 65 years of age since the wear and tear is still greater than ceramic on ceramic. He recommends again ceramic on ceramic for the younger people. I asked about ceramic dislocation and he said that if it gets dislocated you go back to hospital and they put the hip back in place and usally it does not happen again. If it does, they re-do the whole operation. And about the breakage, he said that it happens only in 1 in 80,000. That's good enough for me. Good Luck! Sonia.
 
Good luck on your hip! I have the highly crossed polyethylene hip. I am an athlete. My doctor used this material so that I could continue my activities. Some of the athletes on a different listserve who have had the ceramic on ceramic hip have found it painful to run on later. Continue to gather all of the information about the hips that you can and make sure that your surgeon knows what type of activities you want to particpate in after surgery. I just went in for my 2 year checkup. All is well and I am preparing for a triathlon in June and a 1/2 marathon in January. Oh, I am almost 61 years old. I love my new hip. My other hip which has moderate disease has now stopped hurting so I am very pleased. Again good luck with your new hip(S). You will love them!
Marilyn
 
Hi Marilyn <G>, good to see you here!!


David,
My surgeon also chose metal/poly because he knew I wanted to run again and he felt the ceramic may be a little to brittle. I had both hips replaced last May and am back to running some as well as plenty of other physical activites. The newest generation of poly is suppose to be much harder with less wear than the older ones. The statisitcs look good on paper, I just hope they hold true in my hips!!

Best of luck to you.
Andrea
 
Hi Andrea,
I did my first track night tonight with CMC on the MU Track. Wow! We warmed up with a slow mile. I did 3/4 of one. Then several 100 yard intervals with either high knees or butt kicks. Then we did 5 buddy 400's taking turns. Then 200 buddy pairs and finally a team approach for an 880. It made me really run, not just jog. I was the slow one on the team, but they are so supportive, it made me feel great. I'm looking forward to next week. Glad to see you here! Sounds like things are going well for you too. Isn't life great after THR! I love my new hip! I'm racing the 10th. I'm doing an Octomax at Innsbrook near St. Louis. Talk to you soon!
Marilyn
 
Hi folks ! My name is Stan from Magnolia, De and am brand new to the forum. I have been suffering with a hip that was injured over in Iraq in 2002 and has finally degraded to the point that I gotta have something done as I have to have my wife help me tie shoes (hate to not be able). Anyway Sept 27th I'll be having one of the new generation Oxinium Crosslinked Poly implants for my boogered up right hip. I'm only 50 and asked the question about this type of implant only being for much older patients and my orthopedic doc said absolutely not as I'm still fairly active and still in the reserves as a flyer. He said that even with running the poly should hold up well and I'll probably only need 1 replacement. I sure hope so !!! I am in the medical profession as a lab technologist so I've been doing lots and lots of reading. One thing I have found is that you have to be an informed consumer even when it comes to this as all of the manufacturers think their product is better than everybody elses. Thanks to all of you for sharing your experiences. It is reasuring to know that I can get back to a normal life soon!!!!
 
H Stan,
I am new here too, but it is sooooo good to see an informed, active THR gonnabe! So do you plan on running still? It is great to hear your surgeon is not saying no no. Mind is not thrilled that I want to run still, but he is ok with it.

Marilyn,
ouch what a workout!! We live up a mountain road so I get to do hill repeats often. those can hurt too. I did do a good 35 min run mixed in with some speed walking for a total of 75 min on Monday. Road the bikes hard last night. I am doing a women's only mountainbike clinic tommorrow. Can't wait. I really need work on obstacles. What is an octomax?
Andrea
 
Welcome Stan, I'm also fairly new to this forum. My Doctor asked me to invite the people on the running with THR to post here also. So I did. Thanks Andrea for joining me here. Stan, being informed and letting the doctor know what you expect to do with your hip is important. I'm glad to hear the you have found a doctor who respects a person who is informed and knows that they want to continue to be active. I'm 60 and my doctor doesn't really expect me to wear mine out. No measureable wear so far after 2 years. I'm not sure that he knows how many bike wrecks I have ( about 1 a week) but he does know that I'm on my 3rd bike helmet. I'm getting better though about hitting my head.

Andrea, an Octomax is 1/8 of an Ironman Triathalon. About 1/2 mile open water swim, 14 miles of hills on the bike and a 5 K run. We have some good hills here in Mid-Missouri. I will run walk/the 5 k. I'm hoping to run the 5 k in under 43 minutes my PR.

Have fun at your mountain bike clinic. I need to take one of those. I am still learning to deal with my fear factor of going down a rough gravel or obstacle lined trail. My trainer almost had to peel my fingers off the brakes the other day going down a trail. It is almost an irrational fear of falling. My homework for tomorrow is to ride for 90 minutes. I have my great niece and nephew visiting this week so I will be busy.
Take care all! Isn't life grand with a THR. Stan you will love it!
Marilyn
 
Just have to share my weekend mountainbike clinic with some hippies that like to have fun!!!
Wow, it was great! So impowering. The day was as nasty as it could be, pouring rain, really pouring and a high of only 50 degrees. But the 13 of us ladies never even considered bagging it and we spent 8 hours learning how to ride like the boys. We spent a good 6 hours in the saddle doing drills and then practicing them on the trails. We never did see any of those tough guys out there, just one other really good woman biker. I did some stuff I never thought I could do. Down rock faces, over big roots, downed trees + rocks, up steep gravel, down steep gravel, round sharp turns, fast, mud, mud, mud. Talk about adrenaline rush! By the end of the day, all of us were completely soaked with rain and mud, and wicked proud of ourselves! I did not realize just how exhasted i was until I finally got into my warm vehicle and headed home. Into a hot tub then right into bed where I instantly fell asleep! I learned so much that I can't wait to get out and try some more.

I LOVE MY NEW HIPS!

Andrea
 
Yea Andrea! I am so envious of your fearlessness. I had just about decided to tell my trainer that we needed to back off the downhill stuff. The last one we did really scared me. Maybe I need to do an eight hour clinic. Do they have a really beginning one for scardie cats? Congratulations. I am do the Octomax triathlon this weekend near St. Louis at Innsbruck. I will do lot of big hills but all on paved road. Whew! that is a sigh of relief! :-)
Taking off for Japan next Tuesday for two weeks of sightseeing. We are going to Mt. Fuji next Friday. Hoping to hike part way up while we are there.
Take care everyone! I love my new hip that lets me go traveling.
Marilyn
 
Just curious, do any of you ever get lower back pain (SI joint) attributed to your worn out hips?? I went back to see my ortho doc today as I did too much stair climbing over the weekend and have been paying for it ever since. Anyhow my doc says due to my right hip being shot that my right leg is now about 3/8 ths to 1/2 inch shorter than my left leg and is tilting my pelvis. Anybody else have a similar problem?? September ain't gonnna get here soon enough !!!!!
 
Hi Panamfe,
Yes, I had knee and back pain both. The back pain went away with the surgery. The knee pain took longer, but is gone 95% of the time.
Take care,
Marilyn
 
dkadlec said:
I have very little information on this material and would like to know more before deciding between ceramic or highly cross-linked polyethylene. I am a somewhat athletic 35 year old with arthritis and have to get both hips replaced eventually but I have a lot of questions regarding the newer material.

Has any one heard anything about the newer material referred to as a highly cross-linked polyethylene?

According to my surgeon, ceramic has a potential for cracking and can be dislocated fairly easily.

The highly cross-linked polyethylene can be inserted with a larger ball socket to prevent dislocations, however, the polyethylene has not been tested for very long, that I am aware of.

If anyone has anymore information on either ceramic and/or polyethylene, please let me know.

Thanks,

David
Click to expand...

You should also look into the Biomet M2A Magnum metal on metal option. I am going to have mine done this way in the fall. I'm 50 but very active and my doctor thinks it's better than Ceramic or cross linked poly for me. He does a lot of poly, but for combination of most range of motion, best activity and longest wear, he likes this solution.

I have read that some doctors feel that the poly provides a bit more cushion for running, but I have read on this and other forums that many people with the metal on metal feel absolutely no pain or stress when running.
 
I went to see my ortho doc on Friday to ask a couple of questions about the advantages/disadvantages of the Oxinium Poly vs Ceremic Ceremic. I'm pretty satisfied with doing the Oxinium Poly for a couple of reasons. First off the problem with Nickel being absorbed into the blood with the Ceremic Ceremic. This can be very bad stuff for some people. Evidently there is some sort of test either available or being developed to help screen for potential Nickel serum alergies. Secondly the Oxinium Poly implant is easier to repair as only the liner and ball need to be changed as long as the titanium cup and stem remain fused to the bone. This is generally a 30 minute procedure with much less recovery time than the original THR procedure. Thirdly still being somewhat athletic the poly liner has a bit of a shock absorber effect, be it ever so slight. My doc has been using the Smith and Nephew impants for many years and has seen absolutely no wear in the Poly cup or Oxinium ball. The only failures were ***ociated with the Titanium parts from the implants being over stressed. (Jumping off your roof is not good !) He said the previous generation of poly liners were prone to delaminating resulting in foreign body reactions and loss of bone at the acetabular cup. I had a concern with dislocation and my doc gets around that with a modification that envolves slightly tipping the acetabular cup and modifying the leg length for a tight fit in the joint. He also prefers to use the largest possible liner and ball diameters, especially in men and athletes as you end up with a more stable joint after all is said and done. He also is very conservative in the recovery period with weight bearing. He tends to have people wait a couple extra weeks before full weight bearing .So in short make mine Oxinium Poly. The only thing I wish is that September 27th would get here quicker. My butt hurts bad of late!
 
Hi Stan,

Good to see you here again and glad too hear you have your surgery scheduled. Make sure you keep up your workouts to get strong :).

I have to say at this point in time, I am pretty happy with my metal/poly hips. At my one year checkup, my OS was so pleased with how things looked, nice and tight with plenty of bone growth around the prosesthis, that he lifted all restrictions and told me to "go for it". He said it is highly unlikely that I could dislocate anymore. I have Stryker Acclolade stem with the
Crossfire UHMWPE cup.

Hope your butt feels better soon! :)

Andrea
(Believe in Barbaro)
 
I am 43 and just had THR 3 weeks ago. I did all the research on materials and was all set on ceramic. Then I researched the surgeons and found the #1 hip doc in my city did not like ceramic and preferred chromium steel on cross linked poly (Zimmer). When I researched the crosslinked poly I found it lasts about 40% longer than the non cross linked (in the body, much longer on test machines) however it has the potential to be more brittle and crack. It seems that the reduced wear rate is significant not because it is going to last forever but the wear partials cause the bone to degenerate and the stem to loosen.

All the research I did also told me the number one factor in THR was the surgeon. So far so good Monday will be three weeks since the minimal invasive Watson-Jones surgery and I am walking about ½ mile un ***isted. In addition my legs are perfectly matched, I can bend past 90 degrees and the only precaution I have is that I can’t jump.

I intend to go back to sports skiing and tennis and will probably need a liner replacement in 15 years or so. My surgeon says that is an easy surgery 20 minutes and to make sure that I have the liner replaced at the first signs of any significant wear.

Good luck..



mlourie said:
You should also look into the Biomet M2A Magnum metal on metal option. I am going to have mine done this way in the fall. I'm 50 but very active and my doctor thinks it's better than Ceramic or cross linked poly for me. He does a lot of poly, but for combination of most range of motion, best activity and longest wear, he likes this solution.

I have read that some doctors feel that the poly provides a bit more cushion for running, but I have read on this and other forums that many people with the metal on metal feel absolutely no pain or stress when running.
Click to expand...
 
Had my consult with Lahey surgeon - I like him - he is direct and to the point. Right hip is now bone on bone and left hip is just slightly better. He has agreed in principal to a simulaneous bilateral replacement but says the need to do bone grafts may force a single replacement. At least the initial plan is for a pressed fit (cementless) solution - which if memory serves is what you have Andrea - right?

Obviously more x-rays and tests - but it would seem like I am on way!
Diane
 
Hi Diane,
Well, it sounds like you are headed in the right direction! Hope you are starting to feel positive about all this, it really can be a good thing:) I do have cementless. The 1 yr checkup xrays show wonderful bone growth too. Glad to hear your surgeon will consider simultaneous too. Hope that works for you, it really is an easier way to go if you are ready for it. Really start to get serious about working out to get strong now. Keep us posted!

Andrea
(Believe in Barbaro)
 
Hi Everyone - I hope everyone else finds these forums as helpful and as encouraging as I do. I know it is hard for people not living with the kind of pain and restricted movment we experience understanding someone "looking forward to major surgery".

My doc. put in the intial paperwork to get me into the system/process that Lahey has for all joint replacements. Barring something unforseen it looks like somewhere around October for actual surgery. Andrea - my doc. sounds a lot like yours - he knows we want to be as active as possible and looks at it as a "good thing" (within reason :) ). He also is very pro-active in getting people rehabbed and back out there among the living based on each patient's physical, mental and emotional abilities and committment rather than one size fits all.

I currently do 30-40 minutes of aerobic (recumbent bike, cross trainer) 3-5 times a week and various strength exercises for both upper and lower body. Are there specific exercises anyone did prior to surgery that seemed to make a big difference?

Stay Tuned,
Diane
 
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