Implant survival of 2, 723 vitamin E-infused highly crosslinked polyethylene liners in total hip arthroplasty: data from the Finnish Arthroplasty Register. (4th May 2021)

• Record Type: Journal Article
• Authors: Hemmilä, Matias; Laaksonen, Inari; Matilainen, Markus; Eskelinen, Antti; Haapakoski, Jaason; Puhto, Ari-Pekka; Kettunen, Jukka; Pamilo, Konsta; Mäkelä, Keijo T
• Is Part Of: Acta orthopaedica. Volume 92:Number 3(2021)
• Page Start: 316
• Page End: 322
• Publication Date: 2021-05-04
• Subjects: Orthopedics -- Periodicals; 616.7005
• DOI: 10.1080/17453674.2021.1879513
• Languages: English
• ISSNs: 1745-3674

Abstract

Abstract : Background and purpose — The use of crosslinked polyethylene in total hip arthroplasty (THA) has decreased wear remarkably. It has been suggested that the antioxidative effects of vitamin E may enhance the wear properties of polyethylene even further. This study evaluates revision rates between vitamin E-infused polyethylene liners (E1 and E-poly, ZimmerBiomet, Warsaw, IN, USA) versus moderately crosslinked polyethylene (ModXLPE) liners from the same manufacturer used in primary THA. Patients and methods — We conducted a study based on data from the Finnish Arthroplasty Register. The study group consisted of 2, 723 THAs with a vitamin E-infused liner and a reference group of 2, 707 THAs with a moderately crosslinked polyethylene liner. Survivorship, revision risk, and re-revision causes were compared between groups. Results — The 7-year survival of the vitamin E-infused polyethylene liner group and of the reference group with revision for any reason as the endpoint was comparable (94% [95% CI 92.9–94.9] and 93% [CI 91.9–93.9], respectively). The adjusted hazard ratio (HR) for any revision was similar between the groups (0.7 [CI 0.4–1.1]). When revision for aseptic loosening was studied as the endpoint, the survival for the study group was 99% (CI 98.6–99.4) and for the reference group 99% (CI 98.7–99.5), and the risk of revision was comparable between the study groups (HR 1.3 [CI 0.7–2.5]). Interpretation — After an observation period of 7 years vitamin E-infused liners shows results equal to results obtained with crosslinked polyethylene liners.