Five-Year Experience of Vitamin E–Diffused Highly Cross-Linked Polyethylene Wear in Total Hip Arthroplasty Assessed by Radiostereometric Analysis

Aims Vitamin E-infused highly crosslinked polyethylene (VEPE) has been introduced into total hip arthroplasty (THA) with the aim of further improving the wear characteristics of moderately and highly crosslinked polyethylenes (ModXLPE and HXLPE). There are few studies analyzing the outcomes of vitamin E-infused components in cemented arthroplasty, though early acetabular component migration has been reported. The aim of this study was to measure five-year polyethylene wear and acetabular component stability of a cemented VEPE acetabular component compared with a ModXLPE cemented acetabular component. Methods In a prospective randomized controlled trial (RCT), we assessed polyethylene wear and acetabular component stability (primary outcome) with radiostereometric analysis (RSA) in 68 patients with reverse hybrid THA at five years follow-up. Patients were randomized to either a VEPE or a ModXLPE cemented acetabular component. Results Mean polyethylene wear in the proximal direction was 0.17 mm (SD 0.15) for the VEPE group and 0.20 mm (SD 0.09) for the ModXLPE group (p = 0.005) at five years. Annual proximal wear rates were 0.03 mm/year (VEPE) and 0.04 mm/year (ModXLPE). Total 3D wear was 0.21 mm (SD 0.26) and 0.23 mm (SD 0.10) for the VEPE and ModXLPE groups, respectively (p = 0.009). Total 3D cup translation was 0.72 mm (SD 0.70) (VEPE) and 0.50 mm (SD 0.44) (ModXLPE) (p = 0.409). Conclusion At five years, there was less polyethylene wear in the VEPE group than in the ModXLPE group. Both VEPE and ModXLPE cemented components showed low annual wear rates. Component stability was similar in the two groups and remained constant up to five years. Whether these results will equate to a lower long-term revision rate is still unknown. Cite this article: Bone Joint J 2020;102-B(12):1646–1653.

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Implant survival of 2,723 vitamin E-infused highly crosslinked polyethylene liners in total hip arthroplasty: data from the Finnish Arthroplasty Register

Acta Orthopaedica ◽

10.1080/17453674.2021.1879513 ◽

2021 ◽

pp. 1-7

Author(s):

Matias Hemmilä ◽

Inari Laaksonen ◽

Markus Matilainen ◽

Antti Eskelinen ◽

Jaason Haapakoski ◽

...

Keyword(s):

Vitamin E ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Implant Survival ◽

Arthroplasty Register ◽

Total Hip

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Safety of vitamin E-infused highwall liners for routine use in primary total hip arthroplasty: single centre, short-term follow-up of 1221 cases

Hip International ◽

10.1177/1120700020969644 ◽

2020 ◽

pp. 112070002096964

Author(s):

Kirill Gromov ◽

Nanna H Sillesen ◽

Thomas Kallemose ◽

Henrik Husted ◽

Henrik Malchau ◽

...

Keyword(s):

Patient Safety ◽

Vitamin E ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Single Centre ◽

Short Term ◽

Total Hip ◽

Arthroplasty Registry ◽

Primary Total Hip Arthroplasty

Background: Introduction of new implants should be monitored closely to capture any signs of compromising patient safety. Vitamin E infused highly-crosslinked polyethylene liners (VEPE) offer the potential for reduced wear. Highwall liners have been hypothesised to result in increased wear and potential liner fractures. The aim of this study was to determine the 3–7-year follow-up of highwall VEPE for primary total hip arthroplasty (THA), focusing on liner-related complications. Methods: We included 1221 consecutive THA operations from July 2010 to May 2014 with minimum follow-up of 3 (3.1–6.8) years Data collected included demographics, implant data, complications, reoperations, and deaths. Data were cross-referenced with the Danish Hip Arthroplasty Registry in order to ensure validity and completeness. Acetabular shell position was measured using Martell Hip Analysis Suite in a subgroup of 931 THAs. Results: Cumulative stem revision and shell revision at 3-year follow-up was 3.4% and 0.4% respectively. There were no revisions due to liner failure. Reason for revision included 11 dislocations, 15 soft-tissue revisions for infection, 44 stem revisions of which 34 were periprosthetic fractures and 13 shell revisions of which 6 were combined shell and stem revisions. Conclusion: Early follow-up of VEPE liners for primary THA have not shown any revisions associated with liner failure. Continued monitoring of new materials are necessary to capture any signs of compromised patient safety.

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New Implant Introduction in Total Hip Arthroplasty Using Radiostereometric Analysis: A Cautionary Note

The Journal of Arthroplasty ◽

10.1016/j.arth.2019.10.004 ◽

2020 ◽

Vol 35 (3) ◽

pp. 643-646

Author(s):

Abigail R. Frazer ◽

Michael Tanzer

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Radiostereometric Analysis ◽

Cautionary Note ◽

Total Hip

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Comparison of Polyethylene Wear between Highly Crosslinked and Annealed UHMWPE and Conventional UHMWPE against Ceramic Heads in Total Hip Arthroplasty

Key Engineering Materials ◽

10.4028/www.scientific.net/kem.529-530.279 ◽

2012 ◽

Vol 529-530 ◽

pp. 279-284 ◽

Cited By ~ 1

Author(s):

Taishi Sato ◽

Yasuharu Nakashima ◽

Mio Akiyama ◽

Takuaki Yamamoto ◽

Taro Mawatari ◽

...

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Polyethylene Wear ◽

Wear Rates ◽

Head Penetration ◽

Total Hip ◽

Patient Demographics ◽

Ceramic Femoral Head ◽

Implantation Period

The purpose of this study was to examine the effects of ceramic femoral head material on the wear of annealed, crosslinked ultra-high molecular weight polyethylene (UHMWPE) (XLPE) in total hip arthroplasty compared to non-crosslinked conventional UHMWPE (CPE). XLPE was fabricated by crosslinking with 60 kGy irradiation and annealing. Femoral heads made from zirconia and alumina ceramics, and cobalt-chrome (CoCr) of 22 mm or 26 mm diameter were used. In this study, the femoral head penetration into the cup was measured digitally on radiographs of 70 hips with XLPE and 50 hips with CPE. The average follow-up periods were 6.1 and 12.7 years, respectively. The steady wear rate of XLPE was significantly lower than those of CPE (0.002 versus 0.08 mm/year, respectively). Zirconia displayed increased wear rates compared to alumina in CPE; however, there was no difference among head materials in XLPE (0.0028, 0.011 and 0.009 mm/year for zirconia, alumina and CoCr, respectively). Neither head size or implantation period impacted XLPE wear. In contrast to CPE, XLPE displayed low wear rates surpassing the effects of varying femoral head material, size, implantation period and patient demographics.

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