Is Highly Cross-Linked Polyethylene Safe for Use in High-Flexion Posterior Stabilized Total Knee Arthroplasty?

Young Hoo Kim, Jang Won Park, Young Soo Jang, Eun Jung Kim

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: 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. Methods: 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). Results: The 2 groups did not differ significantly (P > .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. Conclusion: 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.

Original languageEnglish
Pages (from-to)286-292
Number of pages7
JournalJournal of Arthroplasty
Issue number2
StatePublished - Feb 2023

Bibliographical note

Publisher Copyright:
© 2022 Elsevier Inc.


  • conventional polyethylene
  • fracture of tibial polyethylene insert
  • high-flexion LPS-flex prosthesis
  • highly cross-linked polyethylene
  • osteolysis
  • survivorship of TKA prosthesis


Dive into the research topics of 'Is Highly Cross-Linked Polyethylene Safe for Use in High-Flexion Posterior Stabilized Total Knee Arthroplasty?'. Together they form a unique fingerprint.

Cite this