Short-term survivorship of antioxidant highly cross-linked polyethylene liners in total hip arthroplasty reported in American Joint Replacement Registry.

Abstract

Background: Total hip arthroplasty is a safe and effective procedure. To improve survivorship, ultrahigh molecular weight polyethylene hip liners with antioxidants have been developed. Additive antioxidant was deployed to reduce oxidation and consequential wear, loosening, or osteolysis. A unique manufacturing process was utilized for two such hip liners, the Novation^® and Alteon^® XLE hip liners and this research represents the first large series on this specific material. The study hypothesis was that Novation and Alteon XLE hip liners have similar short-term survivorship as other manufacturers' antioxidant liners according to procedure and outcome data from the American Joint Replacement Registry (AJRR).

Aim: To demonstrate similar short-term survivorship of XLE antioxidant hip liners compared to all antioxidant hip liners in AJRR.

Methods: Utilizing total hip arthroplasty data from the AJRR, a retrospective review was performed for subjects who underwent implantation of Novation XLE (n = 461), Alteon XLE (n = 989), or any other antioxidant hip liner (termed the aggregate antioxidant group; n = 39964) as of March 31, 2022. Survivorship at three years and revision rates were compared statistically between the Novation group and the aggregate antioxidant group as well as the Alteon group and the aggregate antioxidant group.

Results: Survivorship at three years post-surgery was 99.09% for Novation, 97.73% for Alteon, and 97.69% for the aggregate antioxidant group. There were no reports of failure due to wear in either the Novation or Alteon groups. Among the revision categories (fracture, infection, aseptic loosening, instability, mechanical complications, wear, pain, hematoma/wound complications, or other), there were no significant differences identified in either comparison. There were also no significant differences in cumulative percent revision rates up to three years post-surgery for the Novation vs aggregate antioxidant group or the Alteon vs aggregate antioxidant group.

Conclusion: Novation and Alteon XLE hip liner revision rate and survivorship are equivalent to other antioxidant hip liners in the short term.