An acetabular component made from highly cross-linked polyethylene enriched with vitamin E: 10-year clinical results and wear rates.

Abstract

A common reason for total hip replacement revisions worldwide is aseptic loosening. To address this issue, a new acetabular component was developed with vitamin E incorporated into its irradiated highly cross-linker polyethylene (HXLPE). Vitamin E might be capable of reducing polyethylene wear by stabilizing free radicals in HLXPE, thus preventing oxidation and enhancing wear resistance. This study aimed to evaluate a vitamin E-enriched HXLPE acetabular component over a 10-year period to assess its impact on wear and osteolysis. A total of 112 patients underwent total hip replacement with a vitamin E blended HXLPE acetabular component. Various assessments were conducted, such as pain scores, patient satisfaction, Harris Hip Score (HHS), amount of femoral head penetration, and radiological parameters. 84 of 112 Patients (75 %) completed the 10-year follow-up. At the 10-year follow-up, patients reported high satisfaction (VAS score: 8.9) and high HHS (93.3). No revision procedure was performed due to instability, two patients underwent revision surgery due to a deep infection, and one patient required revision surgery due to a periprosthetic fracture. The survival rate for aseptic loosening was 100 %, with a 95.5 % rate to revision. The average rate of the femoral head penetration was 0.028 mm/year (SD: 0.011), including a 0.252 mm mean total head penetration (SD: 0.274). Several radiological parameter analyses had been conducted and revealed no abnormalities, equal to the 6-year follow-up. This 10-year follow-up study demonstrated good clinical outcomes of the vitamin E enriched HXLPE acetabular cup with a low wear-rate. These findings suggest that incorporating vitamin E can potentially improve the effectiveness and durability of hip replacement procedures. However, further research comparing it to other polyethylene is required to determine potential clinical superiority.