Abstract

Vitamin E-doped cross-linked polyethylene (VEPE) liners were introduced in total hip arthroplasty (THA) to reduce wear and risk of aseptic loosening and liner fracture. We report this nationwide population-based study to investigate the safety of VEPE liners for THA compared to cross-linked annealed or remelted polyethylene (XLPE). We included THAs from The Danish Hip Arthroplasty Register from January 1, 2008 to June 30, 2019, with uncemented cup, VEPE or XLPE liner, and metal or ceramic head. The outcome was revision due to (1) polyethylene-related endpoints (aseptic loosening, granuloma, osteolysis, or liner fractures) and (2) other endpoints. A total of 110,803 THAs were assessed for eligibility and 53,842 THAs (46,645 patients) were included in the study: 5069 (9.4%) THAs with a VEPE liner and 48,773 (91.6%) with a XLPE liner. Median observation time was 5.48 (interquartile range 3.80-7.15) years for VEPE and 4.85 (interquartile range 2.68-7.76) for XLPE. VEPE had a lower risk of revision for polyethylene-related endpoints compared to XLPE (hazard ratio [HR] 0.60, 95% confidence interval 0.36-0.98) during complete follow-up. THAs with VEPE liners were associated with increased risk of any revision within the first 3 months (HR 1.62, 1.36-1.94), revision recorded as aseptic loosening within 3 months (HR 4.46, 2.26-8.80), and periprosthetic fracture within 3 months (HR 2.57, 1.98, 3.33). VEPE liners had a lower risk of revision due to polyethylene-related endpoints, but a higher risk of all-cause revision within 3 months.

Highlights

  • A major long-term concern in total hip arthroplasty (THA) is revision due to aseptic loosening [1,2,3]

  • A total of 110,803 THAs were assessed for eligibility and 53,842 THAs (46,645 patients) were included in the study, 5,069 (9.4%) THAs with a vitamin E-doped cross-linked polyethylene (VEPE) liner and 48,773 (91.6%) with a XLPE liner

  • VEPE had a lower risk of revision for polyethylene-related endpoints compared to XLPE (hazard ratio (HR) 0.60 95% confidence interval [0.36, 0.98]) during complete follow-up

Read more

Summary

Introduction

A major long-term concern in total hip arthroplasty (THA) is revision due to aseptic loosening [1,2,3]. Journal Pre-proof About a decade ago, a chemical removal of free radicals was proposed This technique uses vitamin E (alpha-tocopherol) to remove free radicals to counteract some of the shelf-life and in vivo oxidation that may lead to delamination and to allow for a further increased rate of cross-linking [7,8,9]. This vitamin E-doped cross-linked polyethylene (VEPE) was introduced on the marked as a new material with a potentially reduced wear profile 9. Journal Pre-proof and risk of aseptic loosening and liner fracture We report this nationwide population-based study to investigate the safety of VEPE liners for THA compared to cross-linked annealed or remelted polyethylene (XLPE)

Objectives
Methods
Results
Discussion
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call