Orthopedics · Joint Replacement — Advanced (THR/TKR Complications, Revision, Bearings, Periprosthetic Fractures)

Highly cross-linked polyethylene (HXLPE) used in modern total hip bearings reduces wear by:

  • A Increasing the molecular weight of the polymer chains
  • B Creating inter-chain covalent bonds via gamma or electron beam radiation reducing adhesive wear
  • C Adding vitamin E to enhance fatigue crack propagation resistance
  • D Reducing the contact area between femoral head and acetabular liner
Correct answer: B. Creating inter-chain covalent bonds via gamma or electron beam radiation reducing adhesive wear

Explanation

High cross-linking of polyethylene is achieved by irradiation (gamma or electron beam at 50–100 kGy), which creates inter-chain covalent bonds (cross-links) that prevent polymer chain pull-out during sliding motion, dramatically reducing adhesive and abrasive wear by up to 90%. The trade-off is reduced fatigue crack resistance (oxidation from free radicals), which is mitigated by remelting or adding vitamin E antioxidant in second-generation HXLPE. Note: option C describes a separate second-generation refinement added after cross-linking, not the primary mechanism of wear reduction.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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