An Uncemented Iso-Elastic Monoblock Acetabular Component: Preliminary Results

Halma, Jelle J.; Eshuis, Rienk; Charles, Hubert; Gaalen, Steven M. van; Gast, Arthur de

doi:10.1016/j.arth.2014.11.017

Cited by 17 publications

(26 citation statements)

References 29 publications

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“…Previous in-vitro studies have already demonstrated that vitamin E blended HXLPE improves fatigue strength and protects against oxidative damage [11,15,17,18]. The protection of HXLPE with vitamin E leads to excellent oxidation resistance [11,13,15,38], which potentially leads to a reduction of wear.…”

Section: Discussionmentioning

confidence: 99%

“…1c). The body of the cup is made of highly-crosslinked UHMW-PE (HXLPE) stabilized with vitamin E [5,11,18].…”

Section: Methodsmentioning

confidence: 99%

“…The titanium coating was developed to maintain the natural elastic properties of isoelastic polyethylene and to promote secondary stability [8,11,18]. Primary stability is achieved by All surgeries were performed using a minimally invasive, antero-lateral approach in standardized surgical technique [26].…”

Section: Methodsmentioning

confidence: 99%

“…This new generation of polythylene promises significantly lower wear rates [2,[11][12][13][14]. However, previous studies have also shown that vitamin E-stabilized HXLPE has similar wear properties to HXLPE without vitamin E, but has improved fatigue strength and is protected from oxidative destruction [11,[15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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The concept of a cementless isoelastic monoblock cup made of highly cross-linked polyethylene infused with vitamin E: Clinical outcome and radiological analyses of migration and wear using EBRA at mid-term follow-up

Afghanyar

Joser

Tecle

et al. 2020

Preprint

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Background The newest generation of cementless titanium coated, isoelastic monoblock cup with vitamin E-blended highly cross-linked polyethylene (HXLPE) has been introduced to the market in 2009. Aim of the present study was to obtain mid-term data including the analyses of migration and wear. Methods The present prospective study investigated 101 primary total hip arthroplasty (THA) cases in 96 patients at a single institution. Patients were allowed full weight-bearing on the first day postoperatively. Harris hip score (HHS) as well as pain and satisfication on visual analogue scale (VAS) were assessed during a mean follow-up of 79.0 months. Migration and wear were assessed using Einzel-Bild-Roentgen-Analyse (EBRA) software. Additionally, radiological alterations in the acetabular bone and complications were documented. Results At mid-term follow-up (mean 79.0 months (range: 51.8 – 101.7)), HHS was 91.1 (range 38.0 – 100.0), satisfaction on VAS was 9.6 (range 6.0 – 10.0), rest pain on VAS was 0.2 (range 0.0 – 4.0), and load pain on VAS was 0.6 (range 0.0 – 9.0). Mean migration was 0.86 mm (range: 0.0 – 2.56) after 24 months and 1.34 mm (range: 0.09 – 3.14) after 5 years. Mean annual migration rate was 0.22 (range: -0.24 – 1.34) at 5 years. Mean total wear was 0.4 mm (range: 0.03 – 1.0) at 5 years. The mean annual wear rate was 0.06 mm per year (range: 0.0 – 0.17). Radiographic analysis showed osteolysis in none of the cases and no revision surgeries had to be performed. Conclusion The concept of vitamin-E blended HXLPE in cementless isoelastic monoblock cups prevents osteolysis, aseptic loosening and the need of revision surgery at mid-term. Values for cup migration and wear stay well below the benchmarks which are considered predictive for potential future failure.

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Section: Discussionmentioning

confidence: 99%

“…1c). The body of the cup is made of highly-crosslinked UHMW-PE (HXLPE) stabilized with vitamin E [5,11,18].…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The concept of a cementless isoelastic monoblock cup made of highly cross-linked polyethylene infused with vitamin E: Clinical outcome and radiological analyses of migration and wear using EBRA at mid-term follow-up

Afghanyar

Joser

Tecle

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…This new generation of polythylene promises signi cantly lower wear rates [2,[11][12][13][14]. However, previous studies have also shown that vitamin E-stabilized HXLPE has similar wear properties to HXLPE without vitamin E, but has improved fatigue strength and is protected from oxidative destruction [11,[15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

The concept of a cementless isoelastic monoblock cup made of highly cross-linked polyethylene infused with vitamin E: Radiological analyses of migration and wear using EBRA and clinical outcomes at mid-term follow-up

Afghanyar

Joser

Tecle

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundThe newest generation of cementless titanium coated, isoelastic monoblock cup with vitamin E-blended highly cross-linked polyethylene (HXLPE) has been introduced to the market in 2009. Aim of the present study was to obtain mid-term data including the analyses of migration and wear.MethodsThe present prospective study investigated 101 primary total hip arthroplasty (THA) cases in 96 patients at a single institution. Patients were allowed full weight-bearing on the first day postoperatively. Harris hip score (HHS) as well as pain and satisfication on visual analogue scale (VAS) were assessed during a mean follow-up of 79.0 months. Migration and wear were assessed using Einzel-Bild-Roentgen-Analyse (EBRA) software. Additionally, radiological alterations in the acetabular bone and complications were documented.ResultsAt mid-term follow-up (mean 79.0 months (range: 51.8 – 101.7)), 81 cases with complete clinical and radiological data were analyzed. In 42 hips utilisable EBRA measurements were obtained. HHS was 91.1 (range 38.0 – 100.0), satisfaction on VAS was 9.6 (range 6.0 – 10.0), rest pain on VAS was 0.2 (range 0.0 – 4.0), and load pain on VAS was 0.6 (range 0.0 – 9.0). Mean migration was 0.86 mm (range: 0.0 – 2.56) at 24 months and 1.34 mm (range: 0.09 – 3.14) at 5 years. Mean annual migration rate was 0.22 (range: -0.24 – 1.34). Mean total wear was 0.4 mm (range: 0.03 – 1.0). The mean annual wear rate was 0.06 mm per year (range: 0.0 – 0.17). Radiographic analysis showed osteolysis in none of the cases and no revision surgeries had to be performed.ConclusionUsing vitamin-E blended HXLPE in cementless isoelastic monoblock cups, no signs of osteolysis were obvious and no cases of aseptic loosening occurred. There was no need of revision surgery at mid-term. Values for cup migration and wear stay well below the benchmarks which are considered predictive for potential future failure.Trial registrationThe trial registration number on ClinicalTrial.gov: NCT04322916 (retrospectively registered at 26.03.2020).

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Effects of vitamin E incorporation in polyethylene on oxidative degradation, wear rates, immune response, and infections in total joint arthroplasty: a review of the current literature

Lambert

Neut

Veen

et al. 2018

International Orthopaedics (SICOT)

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Highly cross-linked ultrahigh molecular weight polyethylene (UHMWPE) was introduced to decrease wear debris and osteolysis. During cross-linking, free radicals are formed, making highly cross-linked polyethylene vulnerable to oxidative degradation. In order to reduce this process, anti-oxidant vitamin E can be incorporated in polyethylene. This review provides an overview of the effects of vitamin E incorporation on major complications in total joint arthroplasty: material failure due to oxidative degradation, wear debris and subsequent periprosthetic osteolysis, and prosthetic joint infections. Secondly, this review summarizes the first clinical results of total hip and knee arthroplasties with vitamin E incorporated highly cross-linked polyethylene. Based on in vitro studies, incorporation of vitamin E in polyethylene provides good oxidative protection and preserves low wear rates. Incorporation of vitamin E may have the beneficial effect of reduced inflammatory response to its wear particles. Some microorganisms showed reduced adherence to vitamin E-incorporated UHMWPE; however, clinical relevance is doubtful. Short-term clinical studies of total hip and knee arthroplasties with vitamin E-incorporated highly cross-linked UHMWPE reported good clinical results and wear rates similar to highly cross-linked UHMWPE without vitamin E.

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An Uncemented Iso-Elastic Monoblock Acetabular Component: Preliminary Results

Cited by 17 publications

References 29 publications

The concept of a cementless isoelastic monoblock cup made of highly cross-linked polyethylene infused with vitamin E: Clinical outcome and radiological analyses of migration and wear using EBRA at mid-term follow-up

The concept of a cementless isoelastic monoblock cup made of highly cross-linked polyethylene infused with vitamin E: Clinical outcome and radiological analyses of migration and wear using EBRA at mid-term follow-up

The concept of a cementless isoelastic monoblock cup made of highly cross-linked polyethylene infused with vitamin E: Radiological analyses of migration and wear using EBRA and clinical outcomes at mid-term follow-up

Effects of vitamin E incorporation in polyethylene on oxidative degradation, wear rates, immune response, and infections in total joint arthroplasty: a review of the current literature

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