Vitamin E-enriched medium cross-linked polyethylene in total knee arthroplasty (VIKEP): clinical outcome, oxidation profile, and wear analysis in comparison to standard polyethylene-study protocol for a randomized controlled trial.

Autor: Maier K; Medical Scientific Affairs, Aesculap AG, Am Aesculap-Platz, 78532, Tuttlingen, Germany. kristin.maier@aesculap.de., Selig M; Medical Scientific Affairs, Aesculap AG, Am Aesculap-Platz, 78532, Tuttlingen, Germany., Haddouche A; Hopital Sud - CHU Grenoble, Avenue Kimberley, 38130, Echirolles, France., Haunschild M; Klinik Für Allgemeine Orthopädie, Endoprothetik Und Kinderorthopädie, Katholisches Klinikum Koblenz-Montabaur, Kardinal-Krementz-Str. 1-5, Koblenz-Montabaur, 56073, Germany., Hauschild O; Department for Orthopedic and Trauma Surgery, Park-Klinik Weissensee, Schönstraße 80, Berlin, 13086, Germany., Khalili I; Krankenhaus Reinbek St. Adolf-Stift, Hamburger Straße 41, 21465, Reinbek, Germany., Kirschberg J; Waldkliniken Eisenberg, Klosterlausnitzer Straße 81, 07607, Eisenberg, Germany., Lutter C; Orthopädische Klinik Und Poliklinik, Universitätsmedizin Rostock, Doberaner Str.142, 18057, Rostock, Germany., Menges M; Lukas Krankenhaus, Hindenburgstraße 56, 32257, Bünde, Germany., Mertl P; CHU Amiens-Picardie, 1 Rond Point du Professeur Christian Cabrol, 80054, CEDEX 1, Amiens, France., Niemeier A; Krankenhaus Reinbek St. Adolf-Stift, Hamburger Straße 41, 21465, Reinbek, Germany., Rubens-Duval B; Hopital Sud - CHU Grenoble, Avenue Kimberley, 38130, Echirolles, France., Mittelmeier W; Orthopädische Klinik Und Poliklinik, Universitätsmedizin Rostock, Doberaner Str.142, 18057, Rostock, Germany.
Jazyk: angličtina
Zdroj: Trials [Trials] 2024 Jan 05; Vol. 25 (1), pp. 27. Date of Electronic Publication: 2024 Jan 05.
DOI: 10.1186/s13063-023-07811-1
Abstrakt: Background: The gliding surface of total knee endoprostheses is exposed to high loads due to patient weight and activity. These implant components are typically manufactured from ultra-high molecular weight polyethylene (UHMWPE). Crosslinking of UHMWPE by ionizing radiation results in higher wear resistance but induces the formation of free radicals which impair mechanical properties after contact with oxygen. Medium-crosslinked UHMWPE enriched with vitamin E (MXE) provides a balance between the parameters for a sustainable gliding surface, i.e., mechanical strength, wear resistance, particle size, and oxidation stability. Therefore, a gliding surface for knee endoprostheses made up from this material was developed, certified, and launched. The aim of this study is to compare this new gliding surface to the established predecessor in a non-inferiority design.
Methods: This multicenter, binational randomized controlled trial will enroll patients with knee osteoarthritis eligible for knee arthroplasty with the index device. Patients will be treated with a knee endoprosthesis with either MXE or a standard gliding surface. Patients will be blinded regarding their treatment. After implantation of the devices, patients will be followed up for 10 years. Besides clinical and patient-related outcomes, radiological data will be collected. In case of revision, the gliding surface will be analyzed biomechanically and regarding the oxidative profile.
Discussion: The comparison between MXE and the standard gliding surface in this study will provide clinical data to confirm preceding biomechanical results in vivo. It is assumed that material-related differences will be identified, i.e., that the new material will be less sensitive to wear and creep. This may become obvious in biomechanical analyses of retrieved implants from revised patients and in radiologic analyses.
Trial Registration: ClinicalTrials.gov, NCT04618016. Registered 27 October 2020, https://clinicaltrials.gov/study/NCT04618016?term=vikep&checkSpell=false&rank=1 . All items from the World Health Organization Trial Registration Data Set can be found in Additional file 1.
(© 2023. The Author(s).)
Databáze: MEDLINE
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