In Vivo Performance of Vitamin E Stabilized Polyethylene Implants for Total Hip Arthroplasty: A Review |
| |
Affiliation: | 1. Implant Research Core, School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA;2. Gyroid, LLC, Haddonfield, NJ;3. 3Spine, Chattanooga, TN;1. Adult Reconstruction and Joint Replacement Service, Division of Orthopaedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy;2. Università Cattolica del Sacro Cuore, Roma, Italy;3. Orthopedic Surgery Division, Department of Medical and Surgical Sciences, University of Catanzaro Magna Græcia, Catanzaro, Italy;1. Duke University School of Medicine, Durham, North Carolina;2. Department of Orthopaedics, Duke University Medical Center, Durham, North Carolina;3. Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, Massachusetts;4. Department of Orthopaedic Surgery, NYU Langone Health, New York, New York |
| |
Abstract: | BackgroundVitamin E stabilization was introduced to improve the oxidative stability, wear resistance, and mechanical properties of highly crosslinked polyethylene (HXLPE). In this literature review, we asked: (1) How has vitamin E-stabilized HXLPE (VEPE) performed in vivo for total hip arthroplasty (THA) and how does it compare with conventional ultra-high molecular weight polyethylene (UHMWPE) and HXLPE without vitamin E; and (2) Is there an apparent difference in the clinical performance of VEPE created by blending versus diffusion?MethodsWe performed a systematic search of the literature according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines using PubMed and Embase. Included studies reported the in vivo behavior of VEPE in THA. We reviewed 41 studies.ResultsFor all studies that compared polyethylene with and without VE stabilization, outcomes for VEPE were either equivalent or superior to the control group (for HXLPE without VE and conventional UHMWPE controls, respectively). Hip insert wear rates were generally less than 0.1 mm/year and in most cases were less than 0.05 mm/year. No VEPE components were revised for osteolysis or adverse outcomes specific to VE incorporation.ConclusionAcross the literature, we found that VEPE was reported to be clinically effective for THA applications, with much of the research indicating positive clinical outcomes and lower or equivalent wear rates compared to conventional UHMWPE and HXLPE controls without VE. Instances of early component fracture were reported, but have multiple potential causes. There is a gap in the literature for comparison of blended and diffused components, so the in vivo impact of VE incorporation method remains to be seen. Overall, this study provides a comprehensive summary of VEPE clinical performance for THA and may serve as a resource for future investigations. |
| |
Keywords: | vitamin E highly crosslinked polyethylene (HXLPE) ultra-high molecular weight polyethylene (UHMWPE) total hip arthroplasty (THA) retrieval |
本文献已被 ScienceDirect 等数据库收录! |
|