Fahd F Mahmood1, Martin Beck2, Arthur de Gast3, Philipp Rehbein4, Gary J French5, Roland Becker6, Martin Dominkus7, Naeder Helmy8, Lutz Hollmann9, Joe Baines1. 1. Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, UK. 2. Luzerner Kantonsspital, Luzern, Switzerland; Orthopaedic Clinic Lucerne, Hirslanden Clinic St. Anna, Lucerne. 3. Diakonessenhuis Utrecht, Utrecht, the Netherlands; Clinical Orthopedic Research Center Midden-Nederland, Diakonessenhuis Zeist, Zeist, the Netherlands. 4. Department of Orthopaedics, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany. 5. Ormiston Hospital, Manukau, New Zealand. 6. Dept. of Orthopedics and Traumatology, Brandenburg Medical School, Brandenburg, Germany. 7. Orthopaedic Department, Orthopädisches Spital Speising, Wien, Austria; Sigmund Freud University, Campus Prater Freudplatz 1, Wien, Austria. 8. Department of Orthopaedics, Nurgerspital Solothurn, Solothurn, Switzerland. 9. Streekziekenhuis Koningin Beatrix, Winterswijk, the Netherlands.
Abstract
BACKGROUND: Addition of vitamin E to polyethylene is theorized to reduce the potential for oxidative wear in acetabular components. This paper presents a multicenter prospective cohort study that reports on outcomes from use of a Vitamin E-infused highly cross-linked polyethylene acetabular cup. METHODS: Patients were recruited across nine medical institutions. Clinical outcome measures recorded were the Harris Hip Score, visual analogue score for pain and satisfaction. Evidence of implant loosening or osteolysis was collected radiologically. Cup survival and reasons for revision in relevant cases were also recorded. Data collection was undertaken preoperatively, at 6-12 weeks, 6 months, 1 year, 2 years, and 5 years. A total of 675 patients were recruited, with 450 cases available at final review. Data regarding cup survival was available to 8 years and 9 months postoperatively. RESULTS: Improvements in both the Harris Hip Score and visual analogue score for pain and satisfaction were recorded at all time points, with these being maintained through the length of follow-up. In total, 89% of cups were implanted within the Lewinnek safe zone. A lucent line was identified in one case, with no evidence of acetabular osteolysis observed throughout the follow-up period. Cup survival was 98.9% at 8 years and 9 months. No revisions for aseptic loosening were observed. CONCLUSIONS: The use of a vitamin E-infused polyethylene acetabular cup demonstrates reassuring patient-reported outcomes, radiological measures, and cup survival at medium to long-term follow-up.
BACKGROUND: Addition of vitamin E to polyethylene is theorized to reduce the potential for oxidative wear in acetabular components. This paper presents a multicenter prospective cohort study that reports on outcomes from use of a Vitamin E-infused highly cross-linked polyethylene acetabular cup. METHODS:Patients were recruited across nine medical institutions. Clinical outcome measures recorded were the Harris Hip Score, visual analogue score for pain and satisfaction. Evidence of implant loosening or osteolysis was collected radiologically. Cup survival and reasons for revision in relevant cases were also recorded. Data collection was undertaken preoperatively, at 6-12 weeks, 6 months, 1 year, 2 years, and 5 years. A total of 675 patients were recruited, with 450 cases available at final review. Data regarding cup survival was available to 8 years and 9 months postoperatively. RESULTS: Improvements in both the Harris Hip Score and visual analogue score for pain and satisfaction were recorded at all time points, with these being maintained through the length of follow-up. In total, 89% of cups were implanted within the Lewinnek safe zone. A lucent line was identified in one case, with no evidence of acetabular osteolysis observed throughout the follow-up period. Cup survival was 98.9% at 8 years and 9 months. No revisions for aseptic loosening were observed. CONCLUSIONS: The use of a vitamin E-infused polyethylene acetabular cup demonstrates reassuring patient-reported outcomes, radiological measures, and cup survival at medium to long-term follow-up.