Implant survival of 2,723 vitamin E-infused highly crosslinked polyethylene liners in total hip arthroplasty: data from the Finnish Arthroplasty Register

Authors

  • Matias Hemmilä Department of Orthopaedic Surgery, University of Turku and Turku University Hospital, Turku
  • Inari Laaksonen Department of Orthopaedic Surgery, University of Turku and Turku University Hospital, Turku
  • Markus Matilainen Turku PET Centre, University of Turku and Turku University Hospital, Turku
  • Antti Eskelinen Coxa Hospital for Joint Replacement and Faculty of Medicine and Health Technologies, Tampere University, Tampere
  • Jaason Haapakoski National Institute for Health and Welfare, Helsinki
  • Ari-Pekka Puhto Division of Operative Care, Department of Orthopaedic and Trauma Surgery, Oulu University Hospital, Oulu
  • Jukka Kettunen Department of Orthopaedics and Traumatology, Kuopio University Hospital, Kuopio, Finland
  • Konsta Pamilo Coxa Hospital for Joint Replacement and Faculty of Medicine and Health Technologies, Tampere University, Tampere
  • Keijo T Mäkelä Department of Orthopaedic Surgery, University of Turku and Turku University Hospital, Turku

DOI:

https://doi.org/10.1080/17453674.2021.1879513

Abstract

Background and purpose — The use of crosslinked polyethylene in total hip arthroplasty (THA) has decreased wear remarkably. It has been suggested that the antioxida- tive effects of vitamin E may enhance the wear properties of polyethylene even further. This study evaluates revision rates between vitamin E-infused polyethylene liners (E1 and E-poly, ZimmerBiomet, Warsaw, IN, USA) versus moderately crosslinked polyethylene (ModXLPE) liners from the same manufacturer used in primary THA.

Patients and methods — We conducted a study based on data from the Finnish Arthroplasty Register. The study group consisted of 2,723 THAs with a vitamin E-infused liner and a reference group of 2,707 THAs with a moderately crosslinked polyethylene liner. Survivorship, revision risk, and re-revision causes were compared between groups.

Results — The 7-year survival of the vitamin E-infused polyethylene liner group and of the reference group with revision for any reason as the endpoint was comparable (94% [95% CI 92.9–94.9] and 93% [CI 91.9–93.9], respectively). The adjusted hazard ratio (HR) for any revision was similar between the groups (0.7 [CI 0.4–1.1]). When revi- sion for aseptic loosening was studied as the endpoint, the survival for the study group was 99% (CI 98.6–99.4) and for the reference group 99% (CI 98.7–99.5), and the risk of revision was comparable between the study groups (HR 1.3 [CI 0.7–2.5]).

Interpretation — After an observation period of 7 years vitamin E-infused liners shows results equal to results obtained with crosslinked polyethylene liners.

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Published

2021-02-01

How to Cite

Hemmilä, M., Laaksonen, I., Matilainen, M., Eskelinen, A., Haapakoski, . J., Puhto, A.-P., Kettunen, J., Pamilo, K., & Mäkelä, K. T. (2021). Implant survival of 2,723 vitamin E-infused highly crosslinked polyethylene liners in total hip arthroplasty: data from the Finnish Arthroplasty Register. Acta Orthopaedica, 92(3), 316–322. https://doi.org/10.1080/17453674.2021.1879513