Vitamin E-diffused polyethylene liners have a high resistance to linear wear after THA
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Despite no notable differences in hip function or pain in patients who underwent total hip arthroplasty, vitamin E-diffused polyethylene liners had “significantly less liner wear” than crosslinked polyethylene liners at 7-year follow-up.
Austin K. Collins, BA, a clinical research coordinator at Massachusetts General Hospital, presented findings of the prospective, multicenter, 7-year comparison study at the Virtual EFORT Congress. Collins and colleagues’ paper won the Silver Award for orthopaedics.
“In 2007, crosslinked polyethylene (XLPE) infused with vitamin E was introduced to potentially prevent long-term issues associated with XLPE, such as embrittlement and oxidation,” Collins said in his presentation.
Collins and colleagues compared radiographic and clinical outcomes, such as acetabular liner wear and patient-reported outcome measures, in 977 patients undergoing THA with to assess safety and non-inferiority of vitamin E-diffused polyethylene (VEPE) liners.
Researchers enrolled patients to 17 centers across eight countries and randomly assigned them to receive either a VEPE or XLPE liner. Data were collected at 1-, 3-, 5- and 7-year postoperative follow-up, including the Harris Hip Score (HHS), a pain numerical rating scale (NRS), a satisfaction NRS and anterior-posterior hip radiographs to measure liner wear.
According to Collins, no patients required revision surgery due to liner wear or failure at 7-year follow-up. He also noted no differences in mean HHS, mean pain NRS or mean satisfaction NRS between the two groups.
“Both cohorts had low liner wear at 7 years. The lower rate exhibited by VEPE was found to be statistically significantly different, indicating VEPE has a higher resistance to liner wear,” Collins said. “However, the liner wear rate in both groups was below the threshold for osteolysis (0.1 mm/year) and no patients in either group were revised for aseptic loosening. This would indicate that at 7-year follow-up, the differences in linear wear rates may not be clinically significant, despite being statistically significant,” he added.
Collins concluded the findings are still valuable as these confirm the safety and non-inferiority of VEPE liner relative to XLPE liners. As the cohort moves toward 10-year follow-up, there is potential to observe embrittlement or oxidation in the XLPE liners, he added.
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Collins AK, et al. Paper 2408. Presented at: Virtual EFORT Congress; Oct. 28-30, 2020.
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