Highly cross-linked polyethylene bearing

Total hip arthroplasty (THA) is the most useful treatment in symptomatic patients with late-stage osteonecrosis of the femoral head (ONFH). Unique features of ONFH such as altered bone remodeling and high prevalence of younger patients may compromise the outcome after THA. Although recent improvements in the implant design, prosthesis fixation, and surgical technique have led to favorable outcomes after THA in patients with ONFH, the optimal choice of the bearing couple is of utmost importance for implant survival in young patients, who might outlive the prosthetic joint. Highly cross-linked polyethylene (HXLPE) bearing provided promising results with reduced wear and low prevalence of osteolysis in midterm studies. However, further studies with long-term follow-up are warranted.