Vitamin E-Diffused Highly Cross-Linked Polyethylene Liner

2016-06-15 17:53:22 | BioPortfolio


Vitamin E incorporated highly cross linked polyethylene (E-XLPE) was developed to increase oxidative resistance of highly cross-linked polyethylene (XLPE) without affecting mechanical properties. The investigators evaluated this type of polyethylene in a randomized clinical study, using Radiostereometric Analysis (RSA). The objective of this study was to compare the early-term wear of E-XLPE to a compression annealed polyethylene liner (C-XLPE, ArComXL®). The clinical outcome at two years was not expected to be affected by the choice of polyethylene.


First generation of modern highly cross-linked polyethylene (XLPE) was clinically introduced in 1998 and has in most countries become standard as bearing surface in total hip arthroplasty. Studies of these materials have shown significantly reduced femoral head penetration when compared to gamma sterilized conventional polyethylene.

Thermaly treating (melting or annealing) is often a part of the manufacturing process of highly cross-linked polyethylenes. The polyethylene is exposed to irradiation to achieve cross-linking and improve wear resistance. Cross-linking by irradiation increases the amount of free radicals in the material.These radicals must be eliminated or stabilized to avoid oxidative degradation over time.Thermal treatment improves oxidation resistance but potentially changes the mechanical properties of the polyethylene.

By annealing i.e. heat treatment under the melt temperature the material maintains better mechanical properties, but elimination of free radicals is suboptimal, which can lead to oxidation in vivo.Heat treatment of the polyethylene above the melt temperature will more effectively reduce or eliminate the amount of residual free radicals. This will increase oxidation resistance, but will negatively influence the mechanical properties of the material.

Due to these limitations new generations of cross-linked polyethylene materials have been developed. Introducing Vitamin E (α-tocopherol), a natural antioxidant into the material prevents oxidative degradation and stabilizes the free radicals found in irradiated polyethylene plastic. In laboratory tests, polyethylene liners with incorporated vitamin-E have demonstrated similar wear, greater strength and better resistance to oxidation compared with the first generation cross-linked polyethylene. Currently, there are only laboratory studies on vitamin E diffused polyethylene available.

The hypothesis in this study is that the early-term E-XLPE wear is low and comparable to a heat-treated XLPE. The investigators also hypothesize that implant fixation and clinical outcome at two years will be unaffected by the choice of polyethylene.

The investigators therefore evaluated the early bedding in and wear in an uncemented arthroplasty supplied with liners made of vitamin E diffusion doped XLPE (E1®, Biomet, Warsaw, IN, USA). In the control group the investigators used the same uncemented hip prosthesis with polyethylene liners manufactured to achieve high levels of crosslinking without sacrificing the mechanical strength and extinguish residual free radicals (ArComXL® , Biomet, Warzaw, IN, USA).

Study Design

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Supportive Care




E-poly, ArComXL




Sahlgrenska University Hospital, Sweden

Results (where available)

View Results


Published on BioPortfolio: 2016-06-15T17:53:22-0400

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A poly(A) binding protein that is involved in promoting the extension of the poly A tails of MRNA. The protein requires a minimum of ten ADENOSINE nucleotides in order for binding to mRNA. Once bound it works in conjunction with CLEAVAGE AND POLYADENYLATION SPECIFICITY FACTOR to stimulate the rate of poly A synthesis by POLY A POLYMERASE. Once poly-A tails reach around 250 nucleotides in length poly(A) binding protein II no longer stimulates POLYADENYLATION. Mutations within a GCG repeat region in the gene for poly(A) binding protein II have been shown to cause the disease MUSCULAR DYSTROPHY, OCULOPHARYNGEAL.

A poly(ADP-ribose) polymerase that contains two ZINC FINGERS in its N-terminal DNA-binding region. It modifies NUCLEAR PROTEINS involved in chromatin architecture and BASE EXCISION REPAIR with POLY ADENOSINE DIPHOSPHATE RIBOSE.

A poly(A) binding protein that has a variety of functions such as mRNA stabilization and protection of RNA from nuclease activity. Although poly(A) binding protein I is considered a major cytoplasmic RNA-binding protein it is also found in the CELL NUCLEUS and may be involved in transport of mRNP particles.

Post-translational modification of proteins with POLY ADENOSINE DIPHOSPHATE RIBOSE.

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