scholarly journals A multicenter approach evaluating the impact of vitamin E-blended polyethylene in cementless total hip replacement

2014 ◽  
Vol 6 (2) ◽  
Author(s):  
Marcus Jäger ◽  
Andrea Van Wasen ◽  
Sebastian Warwas ◽  
Stefan Landgraeber ◽  
Marcel Haversath ◽  
...  
Keyword(s):  
Vitamin E ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Promising Alternative ◽  
Wear Rates ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
The Impact

Since polyethylene is one of the most frequently used biomaterials as a liner in total hip arthroplasty, strong efforts have been made to improve design and material properties over the last 50 years. Antioxidants seems to be a promising alternative to further increase durability and reduce polyethylene wear in long term. As of yet, only <em>in vitro</em> results are available. While they are promising, there is yet no clinical evidence that the new material shows these advantages <em>in vivo</em>. To answer the question if vitamin-E enhanced ultra-high molecular weight polyethylene (UHMWPE) is able to improve long-term survivorship of cementless total hip arthroplasty we initiated a randomized long-term multicenter trial. Designed as a superiority study, the oxidation index assessed in retrieval analyses of explanted liners was chosen as primary parameter. Radiographic results (wear rate, osteolysis, radiolucency) and functional outcome (Harris Hip Scores, University of California-Los Angeles, Hip Disability and Osteoarthritis Outcome Score, Visual Analogue Scale) will serve as secondary parameters. Patients with the indication for a cementless total hip arthroplasty will be asked to participate in the study and will be randomized to either receive a standard hip replacement with a highly cross-linked UHMWPE-X liner or a highly cross-linked vitamin-E supplemented UHMWPE-XE liner. The follow-up will be 15 years, with evaluation after 5, 10 and 15 years. The controlled randomized study has been designed to determine if Vitamin-E supplemented highly cross-linked polyethylene liners are superior to standard XLPE liners in cementless total hip arthroplasty. While several studies have been started to evaluate the influence of vitamin-E, most of them evaluate wear rates and functional results. The approach used for this multicenter study, to analyze the oxidation status of retrieved implants, should make it possible to directly evaluate the ageing process and development of the implant material itself over a time period of 15 years.

Long-Term Outcome of Zürich Cementless Total Hip Arthroplasty in 439 Cases

2015 ◽  
Vol 44 (8) ◽  
pp. 921-929 ◽  
Author(s):  
Luca Vezzoni ◽  
Aldo Vezzoni ◽  
Randy J. Boudrieau
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty

Mid- to Long-Term Survivorship Analysis of a Second-Generation Highly Cross-Linked Polyethylene in Total Hip Arthroplasty

2020 ◽  
Vol 4 (03) ◽  
pp. 124-128
Author(s):  
David Yeroushalmi ◽  
Katherine A. Lygrisse ◽  
Mohamad Sharan ◽  
Nolan A. Maher ◽  
Joseph D. Zuckerman ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Wear Rate ◽  
Hip Arthroplasty ◽  
Second Generation ◽  
Abduction Angle ◽  
Linear Wear ◽  
Wear Rates ◽  
Total Hip

AbstractThe emergence of highly cross-linked polyethylene (HCLPE) has drastically improved survivorship of implants used in total hip arthroplasty (THA), as demonstrated by midterm outcomes. However, there is limited data evaluating long-term outcomes and wear rates of these liners. Therefore, the aim of this study is to evaluate the longest-to-date follow-up of a specific second-generation HCLPE liner, the progression of wear rate, and its relation to acetabular cup positioning. A retrospective study was conducted on patients who underwent THA between January 2001 and December 2005 using a specific second-generation HCLPE liner. Annual liner wear rate (mm/year) was calculated in this group as well as acetabular positioning through abduction angle (degrees). Failures and reason for failures such as periprosthetic fracture, dislocation, and osteolysis were noted when applicable. Forty hips of 35 patients were included in this study with a clinical and radiographic follow-up of 13.4 ± 2.2 years (range: 10.0–16.7 years). Linear and volumetric wear rates were calculated to be 0.037 ± 0.020 mm/year and 22.94 ± 12.07 mm3/year, respectively. No radiographic femoral or acetabular osteolysis was observed in any of the cases. One patient required revision due to complications unrelated to the liner. No significant relationship could be established for acetabular component abduction angle and linear wear rate (p = 0.690, Spearman's rho = 0.03). Our study demonstrates comparable liner wear rates to that of other second-generation HCLPE liners in long-term follow-up. The XLPE liner continues to exhibit minimal progression of linear wear when compared with previous midterm studies and maintains a low rate of postoperative complications requiring revision THA surgery. Further studies are warranted to assess long-term wear and survivorship between this specific liner and comparable HCLPE models.

Cementless Total Hip Arthroplasty with BiCONTACT Stem – Go od Results at Long Term of Follow -up

2014 ◽  
Vol 16 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Marek Drobniewski ◽  
Andrzej Borowski ◽  
Marek Synder ◽  
Marcin Sibiński
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty

scholarly journals Mid- to Long-Term Outcome of Cementless Total Hip Arthroplasty in Younger Patients

2010 ◽  
Vol 18 (2) ◽  
pp. 172-178 ◽  
Author(s):  
Fernando Almeida ◽  
Laura Pino ◽  
Antonio Silvestre ◽  
Francisco Gomar
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Younger Patients ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty

Short Stems Versus Conventional Stems in Cementless Total Hip Arthroplasty: A Long-Term Registry Study

2018 ◽  
Vol 33 (6) ◽  
pp. 1794-1799 ◽  
Author(s):  
Federico Giardina ◽  
Francesco Castagnini ◽  
Susanna Stea ◽  
Barbara Bordini ◽  
Maurizio Montalti ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Registry Study ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
Short Stems

Manufacturing, oxidation, mechanical properties and clinical performance of highly cross-linked polyethylene in total hip arthroplasty

2018 ◽  
Vol 28 (6) ◽  
pp. 573-583 ◽  
Author(s):  
Gurpreet Singh ◽  
Robert Klassen ◽  
James Howard ◽  
Douglas Naudie ◽  
Matthew Teeter ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
First Generation ◽  
Clinical Performance ◽  
Wear Rates ◽  
Total Hip ◽  
Uhmwpe Wear

Ultra-high molecular weight polyethylene (UHMWPE) continues to be the gold standard bearing surface in total hip arthroplasty (THA) for nearly 5 decades. Highly cross-linked UHMWPE (HXLPE) was adapted for routine use in the early 2000s to reduce the revision rates related to wear, osteolysis, and aseptic loosening resulting from conventional UHMWPE wear. Since its inception, consistent evidence showing reduced wear rates and osteolysis supports the use of HXLPE in THA. High quality studies demonstrating the advantage in long term survivorship of HXLPE over conventional UHMWPE are emerging. Though retrieval studies have demonstrated evidence of in vivo oxidation and fatigue related damage at the rim of the first generation HXLPE liners, clinical significance of this remains to be seen. Second-generation sequentially annealed and vitamin E containing HXLPE liners demonstrate improved mechanical properties, resistance to oxidation, and equivalent wear rates in comparison to their first-generation counterparts, but long term success remains to be seen.

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