Vitamin E-doped total hip arthroplasty liners show similar head penetration to highly cross-linked polyethylene at five years: a multi-arm randomized controlled trial

Kristian Kjærgaard*, Ming Ding, Carsten Jensen, Charles Bragdon, Henrik Malchau, Christina Møller Andreasen, Ole Ovesen, Christian Hofbauer, Soren Overgaard

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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Abstrakt

Aims
The most frequent indication for revision surgery in total hip arthroplasty (THA) is aseptic loosening. Aseptic loosening is associated with polyethylene liner wear, and wear may be reduced by using vitamin E-doped
liners. The primary objective of this study was to compare proximal femoral head penetration into the liner between a) two cross-linked polyethylene
(XLPE) liners (vitamin E-doped (vE-PE)) versus standard XLPE liners, and b) two
modular femoral head diameters (32 mm and 36 mm).

Methods
Patients scheduled for a THA were randomized to receive a vE-PE or XLPE liner with a 32 mm or 36 mm metal head (four intervention groups in a 2 × 2 factorial design). Head penetration and acetabular component migration were measured using radiostereometric analysis at baseline, three, 12, 24, and 60 months postoperatively. The Harris Hip Score, University of California, Los Angeles (UCLA) Activity Score, EuroQol five-dimension questionnaire (EQ-5D), and 36-Item Short-Form Health Survey questionnaire (SF-36) were assessed at baseline, three, 12, 36, and 60 months.

Results
Of 220 screened patients, 127 were included in this study. In all, 116 received the allocated intervention, and 94 had their results analyzed at five years. Head penetration was similar between liner materials and head sizes at five years, vE-PE versus XLPE was -0.084 mm (95% confidence interval (CI) -0.173 to 0.005; p = 0.064), and 32 mm versus 36 mm was -0.020 mm (95% CI -0.110 to 0.071; p = 0.671), respectively. No differences were found in acetabular component migration or in the patient-reported outcome measures.

Conclusion
No significant difference in head penetration was found at five years between vE-PE and XLPE liners, nor between 32 mm and 36 mm heads.
OriginalsprogEngelsk
TidsskriftThe Bone & Joint Journal
Vol/bind102-B
Udgave nummer10
Sider (fra-til)1303-1310
ISSN2049-4394
DOI
StatusUdgivet - okt. 2020

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