title: Five-Year Experience of Vitamin E-Diffused Highly Cross-Linked Polyethylene Wear in Total Hip Arthroplasty Assessed by Radiostereometric Analysis.
abstract: Vitamin E-diffused highly cross-linked polyethylene (VEPE) was developed to reduce oxidation without compromising mechanical strength. The purpose of this study was to evaluate VEPE in vivo using radiostereometric analysis (RSA) and patient-reported outcome measures (PROMs).
  
  
  
  Fifty-one hips were enrolled. Each patient received a VEPE liner, a porous titanium shell, and an uncemented stem with a 32-mm cobalt-chrome femoral head. Tantalum beads were inserted into the VEPE to measure femoral head penetration using RSA. RSA radiographs and PROMs were obtained preoperatively immediately after surgery, 6 months, 1, 2, 3, and 5 years after surgery.
  
  
  
  Forty-seven hips returned at 3 years, and 42 hip at 5 years. The mean ± standard error of the mean proximal head penetration into the polyethylene was 0.06 ± 0.01 at 5 years. The amount of head penetration did not change significantly with increasing time in vivo. The mean ± standard error of the mean Harris Hip Score was 58 ± 2 preoperatively, which improved significantly to 93 ± 2 at 5 years (P < .001).
  
  
  
  The head penetration into VEPE liners was low compared with non-VEPE at 5 years. After settling of the liners in the early period, no significant head penetration occurred from 2- to 5-year follow-up. All PROMs improved significantly from preoperative to postoperative and remained very favorable at 5 years. This study documents the longest-term evaluation of in vivo wear performance of VEPE.
authors.affiliation: Department of Orthopaedics, Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Audrey K
authors.initials: AK
authors.lastname: Nebergall
authors.affiliation: Department of Orthopaedics, Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts; Department of Orthopaedics, Copenhagen University Hvidovre Hospital, Hvidovre, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Troelsen
authors.affiliation: Department of Orthopaedics, Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Harry E
authors.initials: HE
authors.lastname: Rubash
authors.affiliation: Department of Orthopaedics, Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Henrik
authors.initials: H
authors.lastname: Malchau
authors.affiliation: Department of Orthopaedics, Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts; Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Ola
authors.initials: O
authors.lastname: Rolfson
authors.affiliation: Department of Orthopaedics, Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Meridith E
authors.initials: ME
authors.lastname: Greene
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002858:Chromium Alloys; D005260:Female; D005270:Femur Head; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D010100:Oxygen / Q000737:chemistry; D020959:Polyethylene / Q000737:chemistry*; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D059869:Radiostereometric Analysis; D057566:Self Report; D012720:Severity of Illness Index; D013314:Stress, Mechanical; D013635:Tantalum / Q000737:chemistry; D013997:Time Factors; D014025:Titanium; D016896:Treatment Outcome; D014810:Vitamin E / Q000737:chemistry*
chemical_list: D002858:Chromium Alloys; D014810:Vitamin E; D013635:Tantalum; D020959:Polyethylene; D014025:Titanium; D010100:Oxygen
keywords: patient-reported outcome measures; polyethylene; radiostereometric analysis; total hip arthroplasty; vitamin E