PMID- 29342060
OWN - NLM
STAT- MEDLINE
DCOM- 20190422
LR  - 20190422
IS  - 1535-1386 (Electronic)
IS  - 0021-9355 (Linking)
VI  - 100
IP  - 2
DP  - 2018 Jan 17
TI  - Creep and Wear in Vitamin E-Infused Highly Cross-Linked Polyethylene Cups for 
      Total Hip Arthroplasty: A Prospective Randomized Controlled Trial.
PG  - 107-114
LID - 10.2106/JBJS.16.01379 [doi]
AB  - BACKGROUND: Aseptic loosening, the most common indication for revision surgery in 
      total hip arthroplasty, can result from osteolysis caused by polyethylene (PE) 
      wear particles. PE wear is increased by age-related oxidation of PE and free 
      radicals emerging during irradiation cross-linking. Diffusion of vitamin E into 
      PE stabilizes free radicals to maintain the biomechanical properties of PE. The 
      purpose of this study was to determine whether vitamin E-infused highly 
      cross-linked PE cups could reduce wear rates. METHODS: We performed a prospective 
      randomized controlled trial, in which 62 patients were allocated to 2 groups: a 
      study group that received a vitamin E-infused highly cross-linked PE (HXLPE/VitE) 
      cup and a control group that received an ultra-high molecular weight PE (UHMWPE) 
      cup. Using radiostereometric analysis, we measured the penetration of the femoral 
      head into the cup 7 days after surgery (baseline) and then again at 6 months and 
      at 1, 2, and 3 years later. RESULTS: Baseline variables did not differ 
      significantly between the groups. At 1, 2, and 3 years after surgery, the 
      HXLPE/VitE cup showed significantly less cumulative penetration (creep and wear) 
      than the UHMWPE cup (p = 0.004, p < 0.0001, and p < 0.0001, respectively). The 
      cumulative penetration after 3 years was 0.200 mm for the HXLPE/VitE cup versus 
      0.317 mm for the UHMWPE cup (p < 0.0001). From 1 to 3 years after surgery, after 
      creep had stabilized and further penetration was mainly due to wear, the mean 
      penetration increased only 0.04 mm in the HXLPE/VitE cup and 0.116 mm in the 
      UHMWPE cup. CONCLUSIONS: Our results confirm that wear rates over the first 3 
      years following surgery were lower in HXLPE/VitE cups than in UHMWPE cups. This 
      suggests that HXLPE/VitE cups may prevent osteolysis, implant loosening, and 
      eventually revision surgery. Long-term follow-up data continue to be collected to 
      confirm these findings. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions 
      for Authors for a complete description of levels of evidence.
FAU - Rochcongar, G
AU  - Rochcongar G
AD  - Department of Orthopedics and Traumatology, Caen University Hospital, Caen, 
      France.
FAU - Buia, G
AU  - Buia G
AD  - Department of Orthopedics and Traumatology, Caen University Hospital, Caen, 
      France.
FAU - Bourroux, E
AU  - Bourroux E
AD  - Department of Orthopedics and Traumatology, Caen University Hospital, Caen, 
      France.
FAU - Dunet, J
AU  - Dunet J
AD  - Department of Orthopedics and Traumatology, Caen University Hospital, Caen, 
      France.
FAU - Chapus, V
AU  - Chapus V
AD  - Department of Orthopedics and Traumatology, Caen University Hospital, Caen, 
      France.
FAU - Hulet, C
AU  - Hulet C
AD  - Department of Orthopedics and Traumatology, Caen University Hospital, Caen, 
      France.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Bone Joint Surg Am
JT  - The Journal of bone and joint surgery. American volume
JID - 0014030
RN  - 0 (Cross-Linking Reagents)
RN  - 1406-18-4 (Vitamin E)
RN  - 9002-88-4 (Polyethylene)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Arthroplasty, Replacement, Hip/*instrumentation
MH  - Biomechanical Phenomena
MH  - Cross-Linking Reagents/chemistry
MH  - Female
MH  - *Hip Prosthesis
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Molecular Weight
MH  - Osteolysis
MH  - Polyethylene/*adverse effects/*chemistry
MH  - Prospective Studies
MH  - *Prosthesis Design
MH  - *Prosthesis Failure
MH  - Radiostereometric Analysis
MH  - Vitamin E/*therapeutic use
EDAT- 2018/01/18 06:00
MHDA- 2019/04/23 06:00
CRDT- 2018/01/18 06:00
PHST- 2018/01/18 06:00 [entrez]
PHST- 2018/01/18 06:00 [pubmed]
PHST- 2019/04/23 06:00 [medline]
AID - 00004623-201801170-00003 [pii]
AID - 10.2106/JBJS.16.01379 [doi]
PST - ppublish
SO  - J Bone Joint Surg Am. 2018 Jan 17;100(2):107-114. doi: 10.2106/JBJS.16.01379.