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Randomized Controlled Trial
. 2020 Dec;91(6):705-710.
doi: 10.1080/17453674.2020.1807220. Epub 2020 Aug 24.

A vitamin E blended highly cross-linked polyethylene acetabular cup results in less wear: 6-year results of a randomized controlled trial in 199 patients

Julie R A Massier  1   2 , Joost H J Van Erp  1   2 , Thom E Snijders  1 , Arthur DE Gast  1   2
Affiliations
Randomized Controlled Trial

A vitamin E blended highly cross-linked polyethylene acetabular cup results in less wear: 6-year results of a randomized controlled trial in 199 patients

Julie R A Massier et al. Acta Orthop. 2020 Dec.

Abstract

Background and purpose - Survivorship of total hip arthroplasty (THA) with the ultra-high molecular weight polyethylene (UHMWPE) monoblock cup has been limited due to periprosthetic osteolysis and aseptic loosening, secondary to wear of the UHMWPE. In response, a vitamin E blended highly cross-linked polyethylene (HXLPE) cup was developed. This study set out to compare the wear and clinical 6-year outcomes of vitamin E blended HXLPE with UHMWPE in an isoelastic monoblock cup in patients with hip osteoarthritis who underwent uncemented THA. The 2-year results have been reported previously. Patients and methods - For this randomized controlled trial 199 patients were included. 102 patients received the vitamin E blended HXLPE uncemented acetabular cup and 97 patients the uncemented UHMWPE monoblock cup. Clinical and radiographic parameters were obtained preoperatively, directly postoperatively, and at 3, 12, 24, and 72 months. Wear rates were compared using the femoral head penetration (FHP) rate. Results - 173 patients (87%) completed the 6-year follow-up. The mean NRS scores for rest pain, load pain, and patient satisfaction were 0.3 (SD 1), 0.6 (SD 1), and 8.6 (SD 1) respectively. The mean Harris Hip Score was 93 (SD 12). The FHP rate was lower in the vitamin E blended HXLPE cup (0.028 mm/year) compared with the UHMWPE cup (0.035 mm/year) (p = 0.002). No adverse reactions associated with the clinical application of vitamin E blended HXLPE were observed. 15 complications occurred, equally distributed between the two cups. The 6-year survival to revision rate was 98% for both cups. There was no aseptic loosening. Interpretation - This study shows the superior performance of the HXLPE blended with vitamin E acetabular cup with clinical and radiographic results similar to the UHMWPE acetabular cup.

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Figures

Figure 1.
Figure 1.
Summary of follow-up.
Figure 2.
Figure 2.
Total femoral head penetration (FHP) in mm and mean FHP rate in mm/year.
Figure 3.
Figure 3.
Numeric Rating Scale and Harris Hip Score.
See this image and copyright information in PMC

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References

    1. Callary S A, Solomon L B, Holubowycz O T, Campbell D G, Munn Z, Howie D W.. Wear of highly crosslinked polyethylene acetabular components. Acta Orthop 2015; 86(2): 159–68. - PMC - PubMed
    1. Devane P A, Horne J G, Ashmore A, Mutimer J, Kim W, Stanley J.. Highly cross-linked polyethylene reduces wear and revision rates in total hip arthroplasty. J Bone Joint Surg 2017; 99(20): 1703–14. - PubMed
    1. Dorr L D, Wan Z, Shahrdar C, Sirianni L, Boutary M, Yun A.. Clinical performance of a Durasul highly cross-linked polyethylene acetabular liner for total hip arthroplasty at five years. J Bone Joint Surg 2005; 87(8): 1816. - PubMed
    1. Dumbleton J H, Manley M T, Edidin A A.. A literature review of the association between wear rate and osteolysis in total hip arthroplasty. J Arthroplasty 2002; 17(5): 649–61. - PubMed
    1. Galea V P, Connelly J W, Shareghi B, Kärrholm J, Sköldenberg O, Salemyr M, Laursen M B, Muratoglu O, Bragdon C, Malchau H.. Evaluation of in vivo wear of vitamin E-diffused highly crosslinked polyethylene at five years. Bone Joint J 2018; 100-B(12): 1592–9. - PubMed

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