The Journal of Bone and Joint Surgery (American). 2008;90:1487-1491.
doi:10.2106/JBJS.F.00991
© 2008 The Journal of Bone and Joint Surgery, Inc.
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Reduction of Osteolysis with Use of Marathon Cross-Linked Polyethylene

A Concise Follow-up, at a Minimum of Five Years, of a Previous Report*

Rudi G. Bitsch, MD1, Travis Loidolt, BA2, Christian Heisel, MD1, Scott Ball, MD2 and Thomas P. Schmalzried, MD2

1 Stiftung Orthopädische Universitätsklinik, Schlierbacher Landstrasse 200A, 69118 Heidelberg, Germany
2 Joint Replacement Institute at Orthopaedic Hospital, 2400 South Flower Street, Los Angeles, CA 90007. E-mail address for T.P. Schmalzried: schmalzried{at}earthlink.net
Investigation performed at the Joint Replacement Institute, Los Angeles, California

* Original Publication

Heisel C, Silva M, dela Rosa MA, Schmalzried TP. Short-term in vivo wear of cross-linked polyethylene. J Bone Joint Surg Am. 2004;86:748-51.

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants of less than $10,000 from the Piedmont Fund of the Los Angeles Orthopaedic Hospital Foundation and a research grant in excess of $10,000 from the Stiftung Orthopädische Universitätsklinik Heidelberg. In addition, one or more of the authors or a member of his or her immediate family received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (DePuy Orthopaedics). Also, a commercial entity (DePuy) paid or directed in any one year, or agreed to pay or direct, benefits of less than $10,000 to a research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which one or more of the authors, or a member of his or her immediate family, is affiliated or associated.

Abstract: We previously reported wear data at a minimum of two years following thirty-four total hip replacements with a Marathon cross-linked polyethylene liner and twenty-four replacements with a conventional (gamma-sterilized-in-air) Enduron polyethylene liner. In this current study, with sequential five-year radiographs, wear rates were determined with use of linear regression analysis. The Marathon polyethylene had average wear rates of 15.4 mm3/yr and 8.0 mm3/million cycles. The Enduron polyethylene had average wear rates of 55.5 mm3/yr and 29.9 mm3/million cycles. The adjusted volumetric wear rate of the Marathon polyethylene was 73% lower than that of the Enduron polyethylene (p = 0.001). Osteolysis developed in eight of the twenty-four hips with an Enduron liner but was not apparent in any hip with a Marathon liner.

Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.


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