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An acetabular component made from highly cross-linked polyethylene enriched with vitamin E: 10-year clinical results
J H J van Erp1,2, H Erisen1, T E Snijders1,2
1Clinical Orthopedic Research Center-mN, Zeist, the Netherlands.
Background:
A common reason for total hip replacement revisions worldwide is aseptic loosening. To address this issue, a new acetabular component was developed with vitamin E incorporated into its irradiated highly cross-linker polyethylene (HXLPE). Vitamin E might be capable of reducing polyethylene wear by stabilizing free radicals in HLXPE, thus preventing oxidation and enhancing wear resistance. This study aimed to evaluate a vitamin E-enriched HXLPE acetabular component over a 10-year period to assess its impact on wear and osteolysis.
Methods:
A total of 112 patients underwent total hip replacement with a vitamin E blended HXLPE acetabular component. Various assessments were conducted, such as pain scores, patient satisfaction, Harris Hip Score (HHS), amount of femoral head penetration, and radiological parameters.
Results:
84 of 112 Patients (75 %) completed the 10-year follow-up. At the 10-year follow-up, patients reported high satisfaction (VAS score: 8.9) and high HHS (93.3). No revision procedure was performed due to instability, two patients underwent revision surgery due to a deep infection, and one patient required revision surgery due to a periprosthetic fracture. The survival rate for aseptic loosening was 100 %, with a 95.5 % rate to revision. The average rate of the femoral head penetration was 0.028 mm/year (SD: 0.011), including a 0.252 mm mean total head penetration (SD: 0.274). Several radiological parameter analyses had been conducted and revealed no abnormalities, equal to the 6-year follow-up.
Conclusion:
This 10-year follow-up study demonstrated good clinical outcomes of the vitamin E enriched HXLPE acetabular cup with a low wear-rate. These findings suggest that incorporating vitamin E can potentially improve the effectiveness and durability of hip replacement procedures. However, further research comparing it to other polyethylene is required to determine potential clinical superiority.
