Alternatives to Conventional UHMWPE for Hip Arthroplasty

This chapter first summarizes MOM and COC alternative bearing designs and some of the unique risks associated with their use. The history of MOM bearings is particularly noteworthy, because it predates the use of UHMWPE in artificial hip joints. We also review the use of ceramics as a counter face in articulations with UHMWPE. For all practical purposes, however, highly crosslinked UHMWPE remains the most widely used alternative to conventional UHMWPE in orthopedics today. Thus, this chapter also summarizes the development of highly crosslinked and thermally stabilized UHMWPE and describes the characteristics of the most prevalent alternative to conventional UHMWPE in joint arthroplasty. 

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This chapter contains four main sections covering TKA and, where applicable, UKA. The first section reviews the biomechanical considerations of knee arthroplasty that distinguish it from hip replacement. The second section describes the survivorship of TKA and UKA, and outlines measures of clinical performance for UHMWPE in knee arthroplasty. The third section is devoted to wear and osteolysis in TKA. In the final section of this chapter, alternatives to metal-on-conventional UHMWPE articulation for knee arttiroplasty are described. 

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