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Wear of Vitamin E-Infused Highly Cross-Linked Polyethylene at Five Years

Journal article
Authors Bita Shareghi
Per-Erik Johanson
Johan Kärrholm
Published in Journal of Bone and Joint Surgery-American Volume
Volume 99
Issue 17
Pages 1447-1452
ISSN 0021-9355
Publication year 2017
Published at Institute of Clinical Sciences, Department of Orthopaedics
Pages 1447-1452
Language en
Keywords total hip-arthroplasty, molecular-weight polyethylene, radiostereometric, analysis, 5-year experience, controlled-trial, liner, rsa, Orthopedics, Surgery
Subject categories Orthopaedics, Orthopedics


Background: In an earlier study with a 2-year follow-up of uncemented cups, we had reported low femoral-head penetration of vitamin E-infused highly cross-linked polyethylene liners (E1) compared with highly cross-linked liners without vitamin E (ArComXL). We studied the penetration rate of E1 compared with that of ArComXL, with a focus on changes occurring between 2 and 5 years after total hip arthroplasty. Methods: In this randomized controlled study, we performed radiostereometric analysis of the penetration rate up to 5 years in 63 hips. Results: During the total period of observation, the median proximal penetration for E1, 0.13 mm (mean, 0.11 mm [95% confidence interval (CI), 0.08 to 0.14 mm]), was lower than that for ArComXL, 0.20 mm (mean, 0.22 mm [95% CI, 0.17 to 0.26 mm]). The median proximal penetration rate between 2 and 5 years was 0.02 mm/yr (mean, 0.01 mm/yr [95% CI, 0.01 to 0.02 mm/yr]) for E1 and 0.04 mm/yr (mean, 0.04 mm/yr [95% CI, 0.03 to 0.05 mm/yr) for ArComXL. The corresponding median total (i.e., 3-dimensional resultant) penetration rates were 0.04 mm/yr (mean, 0.04 mm/yr [95% CI, 0.03 to 0.05 mm/yr]) for E1 and 0.07 mm/yr (mean, 0.08 mm/yr [95% CI, 0.06 to 0.10 mm/yr]) for ArComXL. Conclusions: From years 2 to 5, we observed increased penetration in both groups. The penetration rate was higher for ArComXL, resulting in more proximal and total penetration at 5 years than for E1. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

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