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A Review of Early In Vivo Performance of Antioxidant Stabilized Polyethylene for Total Knee Arthroplasty
Journal article   Peer reviewed

A Review of Early In Vivo Performance of Antioxidant Stabilized Polyethylene for Total Knee Arthroplasty

Hannah Spece, Ron Yarbrough and Steven M Kurtz
The Journal of arthroplasty, v 38(9), pp 1885-1891
20 Feb 2023
PMID: 36813217

Abstract

total knee arthroplasty antioxidant ultra-high molecular weight polyethylene highly crosslinked polyethylene vitamin E
The incorporation of antioxidants into highly crosslinked polyethylene (HXLPE) has emerged as an alternative to post-irradiation thermal treatments for improving oxidation resistance. Currently, use of antioxidant stabilized HXLPE (AO-XLPE) in total knee arthroplasty (TKA) is increasing. In this literature review, we asked: (1) How does the clinical performance of AO-XLPE compare to conventional ultra-high molecular weight polyethylene (UHMWPE) or HXLPE for TKA; (2) What material changes occur in vivo for AO-XLPE in TKA; and (3) What is the risk of revision for AO-XLPE in TKA? We performed a search of the literature according to PRISMA guidelines using PubMed and Embase. Included studies reported the in vivo behavior of vitamin E-doped polyethylene in TKA. We reviewed 13 studies. Across the studies, clinical results including revision rates, patient reported outcome measurement scores, and the occurrence of osteolysis or radiolucent lines tended to be similar for AO-XLPE as compared to conventional UHMWPE or HXLPE controls. In retrieval analyses, AO-XLPE exhibited excellent resistance to oxidation and typical surface damage. Survival rates were positive and not significantly different from conventional or highly crosslinked polyethylene. There were no cases of osteolysis for AO-XLPE and no revision due to polyethylene wear reported. The purpose of this review was to provide a comprehensive overview of the literature regarding the clinical effectiveness of AO-XLPE in TKA. Overall, the results of our review indicated positive early- to mid-term clinical performance for AO-XLPE in TKA and similar outcomes as compared to conventional UHMWPE and HXLPE.

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Web of Science research areas
Orthopedics
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