The addition of vitamin E could reduce femoral head penetration of the polyethylene liners
Abstract Background Vitamin E-diffused highly cross-linked polyethylene (HXLPE/Vit E) is a relatively advanced material used in total hip arthroplasty (THA) but whether it shows superiority is unclear. Objective This meta-analysis was performed to investigate the effect of HXLPE/Vit E liners in THA....
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| Language: | English |
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BMC
2025-01-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-024-05402-7 |
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| author | Fanxiao Liu Ling Gao Dawei Wang Qingyu Zhang |
| author_facet | Fanxiao Liu Ling Gao Dawei Wang Qingyu Zhang |
| author_sort | Fanxiao Liu |
| collection | DOAJ |
| description | Abstract Background Vitamin E-diffused highly cross-linked polyethylene (HXLPE/Vit E) is a relatively advanced material used in total hip arthroplasty (THA) but whether it shows superiority is unclear. Objective This meta-analysis was performed to investigate the effect of HXLPE/Vit E liners in THA. Methods Medline/PubMed, Embase and Cochrane Library databases were searched to retrieve studies assessing the efficacy of HXLPE/Vit E liners in THA with the design of a randomized, controlled trial. Meta-analyses were conducted to merge the outcome estimates of interest, such as the femoral head penetration (FHP), FHP rate, FHP in x- (medial/lateral), y- (vertical) and z- (anteroposterior) axes, cup inclination angle, Harris hip score (HHS), numeric rating scale (NRS) and complications. Then pooled outcomes at different time points during the follow-up period were calculated. Results Follow an elaborate search of related databases, 23 studies involving a total of 54,920 participants were deemed eligible for this meta-analysis. The pooled results revealed significant decreased FHP at the last follow-up (pooled Mean Difference [MD] = -0.10, 95% confidence intervals [CIs]: -0.14 to -0.06). The subgroup analysis revealed a consistent trend at different time points during the follow-up. Significant decrease in the FHP rate were identified at the postoperative 1–2 years (pooled MD = -0.01, 95% CIs: -0.02 to -0.00) rather than at 2–5, 5–7, and 7–10 years. The combined results of clinical scores demonstrated no significant changes in the HHS, NRS, and EQ-5D variables. Additionally, no significant differences in the revision and cup inclination angle were identified during the follow-up period. Conclusions This study indicated that HXLPE/Vit E liner in total hip arthroplasty may decrease the femoral head penetration, mainly due to the decreased wear in proximal directions. However, no improvement on the clinical functions and complications were identified, and whether HXLPE/Vit E has the potential to prevent implant loosening or revision surgery could not be identified, which requires to be elaborated by high-quality randomized controlled trials. |
| format | Article |
| id | doaj-art-13f54e0454264cbf8d1e5743fb0658a1 |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-13f54e0454264cbf8d1e5743fb0658a12025-01-26T12:43:35ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-01-0120111310.1186/s13018-024-05402-7The addition of vitamin E could reduce femoral head penetration of the polyethylene linersFanxiao Liu0Ling Gao1Dawei Wang2Qingyu Zhang3Department of Orthopaedics, Liaocheng People’s HospitalScientific Center, Shandong Provincial Hospital, Shandong UniversityDepartment of Orthopaedics, Liaocheng People’s HospitalDepartment of Orthopaedics, Liaocheng People’s HospitalAbstract Background Vitamin E-diffused highly cross-linked polyethylene (HXLPE/Vit E) is a relatively advanced material used in total hip arthroplasty (THA) but whether it shows superiority is unclear. Objective This meta-analysis was performed to investigate the effect of HXLPE/Vit E liners in THA. Methods Medline/PubMed, Embase and Cochrane Library databases were searched to retrieve studies assessing the efficacy of HXLPE/Vit E liners in THA with the design of a randomized, controlled trial. Meta-analyses were conducted to merge the outcome estimates of interest, such as the femoral head penetration (FHP), FHP rate, FHP in x- (medial/lateral), y- (vertical) and z- (anteroposterior) axes, cup inclination angle, Harris hip score (HHS), numeric rating scale (NRS) and complications. Then pooled outcomes at different time points during the follow-up period were calculated. Results Follow an elaborate search of related databases, 23 studies involving a total of 54,920 participants were deemed eligible for this meta-analysis. The pooled results revealed significant decreased FHP at the last follow-up (pooled Mean Difference [MD] = -0.10, 95% confidence intervals [CIs]: -0.14 to -0.06). The subgroup analysis revealed a consistent trend at different time points during the follow-up. Significant decrease in the FHP rate were identified at the postoperative 1–2 years (pooled MD = -0.01, 95% CIs: -0.02 to -0.00) rather than at 2–5, 5–7, and 7–10 years. The combined results of clinical scores demonstrated no significant changes in the HHS, NRS, and EQ-5D variables. Additionally, no significant differences in the revision and cup inclination angle were identified during the follow-up period. Conclusions This study indicated that HXLPE/Vit E liner in total hip arthroplasty may decrease the femoral head penetration, mainly due to the decreased wear in proximal directions. However, no improvement on the clinical functions and complications were identified, and whether HXLPE/Vit E has the potential to prevent implant loosening or revision surgery could not be identified, which requires to be elaborated by high-quality randomized controlled trials.https://doi.org/10.1186/s13018-024-05402-7Total hip arthroplastyVitamin ERCTMeta-analysisFemoral head penetration |
| spellingShingle | Fanxiao Liu Ling Gao Dawei Wang Qingyu Zhang The addition of vitamin E could reduce femoral head penetration of the polyethylene liners Journal of Orthopaedic Surgery and Research Total hip arthroplasty Vitamin E RCT Meta-analysis Femoral head penetration |
| title | The addition of vitamin E could reduce femoral head penetration of the polyethylene liners |
| title_full | The addition of vitamin E could reduce femoral head penetration of the polyethylene liners |
| title_fullStr | The addition of vitamin E could reduce femoral head penetration of the polyethylene liners |
| title_full_unstemmed | The addition of vitamin E could reduce femoral head penetration of the polyethylene liners |
| title_short | The addition of vitamin E could reduce femoral head penetration of the polyethylene liners |
| title_sort | addition of vitamin e could reduce femoral head penetration of the polyethylene liners |
| topic | Total hip arthroplasty Vitamin E RCT Meta-analysis Femoral head penetration |
| url | https://doi.org/10.1186/s13018-024-05402-7 |
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