The addition of vitamin E could reduce femoral head penetration of the polyethylene liners.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(10):2 J Orthop Surg Res . 2025 Jan 20;20(1):72.What this means for my practice?
Clinicians should remember that vitamin E-diffused polyethylene liners effectively reduce polyethylene wear, particularly femoral head penetration, but do not improve clinical outcomes or complication rates in THA. Although promising for liner longevity, current evidence does not confirm reduced implant loosening or revision surgery risk. The major limitation of this meta-analysis is the limited duration of follow-up, restricting long-term conclusions.
Study Summary
Twenty-three randomized controlled trials including 54,920 patients undergoing total hip arthroplasty were included in this systematic review and meta-analysis comparing vitamin E-diffused highly cross-linked polyethylene (HXLPE/Vit E) liners versus polyethylene liners without vitamin E. Pooled outcomes included femoral head penetration (FHP), FHP rate, directional FHP (mediolateral, vertical, anteroposterior), Harris Hip Score (HHS), numeric rating scale (NRS), and complications. The meta-analysis demonstrated significantly decreased femoral head penetration at the final follow-up, especially in the vertical direction. However, there were no significant differences in clinical scores (HHS, NRS), complication rates, or revision rates between groups. These findings suggest that while vitamin E supplementation reduces liner wear, it does not lead to notable clinical improvements or fewer complications.
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