Exactech GXL Hip Implant Liners

Exactech has found that its GXL hip implant liners may be prone to a high rate of early failure, putting some patients at a higher risk of complications due to premature wear. Patients who received this implant during a primary or revision hip replacement surgery may require additional surgery to remedy the damage caused by the defective liner.

What are Hip Implant Liners?

Hip implant liners, also known as acetabular liners, are one of several parts of a complete hip implant. Made of plastic or ceramic, they often line the area between the ball of the hip socket and the cup it fits into to allow the implanted components to move freely and smoothly.

The  Connexion GXL acetabular liner, manufactured by Exactech and made from a plastic called polyethylene, was designed to be used in total hip replacement surgeries (primary and revision) working with other Exactech brand hip replacement systems (Acumatch, MCS Systems and Novation). The liners are typically used for those who need a total hip replacement due to joint-degrading conditions such as osteoarthritis and rheumatoid arthritis, and bone damage resulting from trauma or disease.

Exactech marketed the Connexion GXL liner as being more resistant to wear and fracture; however, some studies have reported osteolysis in patients with the liner.

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What is the problem?

Premature wear of a polyethylene liner can cause serious damage to a person’s hip joint and result in the need for a revision surgery. According to research reports, Exactech’s GXL hip liners have been known to deteriorate earlier than expected due to a design flaw.

  • Two studies reported concerns that the product was prone to early failure, which occurred an average of five years following the surgery and in some cases less than a year after being implanted.
  • Exactech reports that early failure of the polyethylene liner appears to be more pronounced in patients with larger femoral heads paired with the thinnest available liner; in more active patients; and with a certain type of total hip replacement surgical approach.

Premature wear of the GXL acetabular liners has led to complications such as osteolysis, component loosening, tissue damage and other serious complications.

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Warning signs of product failure include:

  • Hip pain
  • Stiffness
  • Limited range of motion/mobility
  • Difficulty walking
  • Weakening or loosening of the joint
  • Osteolysis

A serious complication that can develop, osteolysis, is a progressive condition where bone tissue is destroyed. In this process, bones lose minerals, soften and become weaker. One type of osteolysis can occur as a complication of joint replacement surgery. This is where polyethylene or other materials in a hip implant can wear down. Debris accumulates in the surrounding joint tissue and bone, which can lead to implant loosening and premature revision surgery.

Have You Experienced Premature Failure of Your Device?

Studies Raise Concerns

Two 2020 studies, one published in the Journal of Arthroplasty and one in Arthroplasty Today, found Exactech Connexion GXL liner may be prone to a high rate of early failure.

One study found the average time before the implants failed was 55.9 months (about 5 years). According to the authors, “The Exactech Connexion GXL liner may be prone to a high rate of early failure from wear and severe secondary osteolysis. We recommend close surveillance of patients with this bearing surface.”

The authors of both studies concluded it could be potential design flaws causing these problems with early wear.


Have you heard from your surgeon?

Exactech’s communication to surgeons recommended that GXL patients who are less than six years from index surgery and who have not been seen in over 12 months, return to their physician for a routine clinical exam and x-rays to properly evaluate the status of their implant.

When you have questions, we are here for you. Contact us at (877) 284-6600.


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If you have been advised to undergo a revision surgery, or have already had one, due to complications associated with the Exactech Connexion GXL hip implant liner, contact the law offices of  Nash & Franciskato at (877) 284-6600. The time to request your free, no-obligation case review is today. We will review your case in a free and confidential consultation, with no risk or obligation to take legal action.

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