Migration and head penetration of Vitamin-E diffused cemented polyethylene cup compared to standard cemented cup in total hip arthroplasty: study protocol for a randomised, double-blind, controlled trial (E1 HIP)

Olof Sköldenberg, Agata Rysinska, Ghazi Chammout, Mats Salemyr, Olle Muren, Henrik Bodén, Thomas Eisler, Olof Sköldenberg, Agata Rysinska, Ghazi Chammout, Mats Salemyr, Olle Muren, Henrik Bodén, Thomas Eisler

Abstract

Introduction: In vitro, Vitamin-E-diffused, highly cross-linked polyethylene (PE) has been shown to have superior wear resistance and improved mechanical properties when compared to those of standard highly cross-linked PE liners used in total hip arthroplasty (THA). The aim of the study is to evaluate the safety of a new cemented acetabular cup with Vitamin-E-doped PE regarding migration, head penetration and clinical results.

Methods and analysis: In this single-centre, double-blinded, randomised controlled trial, we will include 50 patients with primary hip osteoarthritis scheduled for THA and randomise them in a 1:1 ratio to a cemented cup with either argon gas-sterilised PE (control group) or Vitamin-E-diffused PE (vitamin-e group). All patients and the assessor of the primary outcome will be blinded and the same uncemented stem will be used for all participants. The primary end point will be proximal migration of the cup at 2 years after surgery measured with radiostereometry. Secondary end points include proximal migration at other follow-ups, total migration, femoral head penetration, clinical outcome scores and hip-related complications. Patients will be followed up at 3 months and at 1, 2, 5 and 10 years postoperatively.

Results: Results will be analysed using 95% CIs for the effect size. A regression model will also be used to adjust for stratification factors.

Ethics and dissemination: The ethical committee at Karolinska Institutet has approved the study. The first results from the study will be disseminated to the medical community via presentations and publications in relevant medical journals when the last patient included has been followed up for 2 years.

Trial registration number: NCT02254980.

Keywords: Radiostereometry; Total hip arthroplasty; Vitamin-E; cemented cup; highly cross-linked polyethylene.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Figures

Figure 1
Figure 1
Blood test, serum C-terminal telopeptide of type I collagen (SCTx), pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (1CTP), C reactive protein (CRP), IL-6, Hb; EQ-5D, quality of life score; HHS, Harris hip score; HOOS, Hip Osteoarthritis Outcome Score; m, month; RSA, radiostereometry; v, week; VAS, visual analogue scale for hip pain; X-ray, anterioposterior and lateral radiographs; y, year.

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