Vitamin E diffused highly cross-linked polyethylene in total hip arthroplasty at five years

Nebergall, Audrey; Greene, Meridith E.; Laursen, Mogens Berg; Nielsen, Poul; Malchau, Henrik; Troelsen, Anders

doi:10.1302/0301-620x.99b5.37521

Cited by 59 publications

(46 citation statements)

References 29 publications

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“…liners, where steady state wear rates between 1 and 10 µm/year have been found [19][20][21][22], and is considerably below the osteolysis threshold wear rate of 100 µm/ year [23]. Short-term follow-up studies of xlpe liners with vitamin e content also show similar wear rates as those from xlpe previously mentioned [16,17,24,25]. However, this excellent wear characteristics of the xlpe at the long-term are in question, as studies have demonstrated in vivo oxidation of annealed xlpe by means of cyclic fatigue loading and fluid absorption, whereas remelting of xlpe leads to a reduction of its mechanical properties [26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 76%

“…as highly cross-linked polyethylene with vitamin e content (either blended or diffused) is a relatively new material, there are currently no long-term follow-up studies available to compare the results obtained in the current in vitro study. Nevertheless, short-term follow-up studies have shown a similar performance between xlpe liners with and without vitamin e content [16,17]. Vitamin e does not provide additional wear resistance to the polyethylene after highly crosslinking, but prevents its oxidation, and thus it is expected to maintain its excellent wear characteristics through time.…”

Section: Discussionmentioning

confidence: 99%

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Articulation and Backside Wear Analysis After Long-Term in Vitro Wear Simulation of Vitamin E Stabilized Polyethylene Acetabular Liners With a Press-Fit Locking Mechanism

Reyna

Holderied

Jäger³

et al. 2018

Traumatology and Orthopedics of Russia

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A previous retrieval study analyzed the backside wear of short-term implanted liners against in vitro tested liners of similar life in service and showed comparable results among both groups, with no significant backside wear due to micro-motion.The purpose — to obtain a picture of the overall wear (articulation and backside surfaces) of 0.1% vitamin e blended polyethylene liners, with a locking mechanism based on a press-fit cone in combination with a rough titanium conical inner surface in the fixation area, under a 20 million cycles hip wear simulation.Materials and Methods. A semi-quantitative method was used in order to assess the damage on the backside of the liners and a 3d measuring machine to assess the creep and wear at the articulation surface.Results. The total average backside wear score was 22.00±2.59 from a maximum total score of 147 after 5 million cycles (mc), increased to 31.92±5.57 after 10 mc, but showed no further increment after 15 and 20 mc. The reference liners (subjected only to axial load) showed similar wear scores and modes as the liners under wear simulation (axial load and movement). Small scratches produced during insertion and removal were clearly seen at the rim (fixation) area and no considerable abrasion was observed. The machining marks on the convex surface were always visible. Regarding the articulation surface, a steady state wear rate of 7 µm/year was measured.Conlusion. These results determined that most of the backside wear produced on the liners occurred during their insertion and removal rather than during their life in service. Moreover, the wear at the articulation surface was similar to that seen in vivo at short- and mid-term on highly cross-linked polyethylene liners with and without vitamin e content.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Articulation and Backside Wear Analysis After Long-Term in Vitro Wear Simulation of Vitamin E Stabilized Polyethylene Acetabular Liners With a Press-Fit Locking Mechanism

Reyna

Holderied

Jäger³

et al. 2018

Traumatology and Orthopedics of Russia

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“…Other Level-I and II studies demonstrated significantly less wear for vitamin E-infused HXLPE compared with UHMWPE 20 , medium cross-linked polyethylene 21 , and HXLPE without vitamin E 22 at mid-term follow-up.…”

Section: Highly Cross-linked Polyethylene (Hxlpe)mentioning

confidence: 87%

What’s New in Hip Replacement

Glassman

2018

The Journal of Bone and Joint Surgery

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“…As a consequence, the liner can also be thinner and larger heads can be used, with a possible improvement in joint stability. While the early clinical results are promising, with a low wear rate reported even with 36-mm diameter heads, the follow-up is still too short to evaluate potential clinical advantages over regular XLPE liners 34 - 36 and registry data show no difference between XLPE and Vitamin E XLPE. 5…”

Section: Conventional and Cross-linked Polyethylenementioning

confidence: 99%

Bearing surfaces in primary total hip arthroplasty

Zagra

Gallazzi

2018

EFORT Open Reviews

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Total hip arthroplasty (THA) is widely considered one of the most successful surgical procedures in orthopaedics. It is associated with high satisfaction rates and significant improvements in quality of life following surgery. On the other hand, the main cause of late revision is osteolysis and wear, often a result of failure of bearing surfaces.Currently, several options are available to the surgeon when choosing the bearing surface in THA (ceramic-on-ceramic (CoC), ceramic-on-polyethylene (CoPE), metal-on-polyethylene (MoPE)), each with advantages and drawbacks.Very few studies have directly compared the various combinations of bearings at long-term follow-up. Randomized controlled trials show similar short- to mid-term survivorship among the best performing bearing surfaces (CoC, CoXLPE and MoXLPE). Selection of the bearing surface is often ‘experience-based’ rather than ‘evidence-based’.The aim of this paper is therefore to evaluate the main advantages and drawbacks of various types of tribology in THA, while providing practical suggestions for the surgeon on the most suitable bearing surface option for each patient.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.180300.

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Vitamin E diffused highly cross-linked polyethylene in total hip arthroplasty at five years

Cited by 59 publications

References 29 publications

Articulation and Backside Wear Analysis After Long-Term in Vitro Wear Simulation of Vitamin E Stabilized Polyethylene Acetabular Liners With a Press-Fit Locking Mechanism

Articulation and Backside Wear Analysis After Long-Term in Vitro Wear Simulation of Vitamin E Stabilized Polyethylene Acetabular Liners With a Press-Fit Locking Mechanism

What’s New in Hip Replacement

Bearing surfaces in primary total hip arthroplasty

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