Research

Better wear and antibacterial?

One of the lesser sung innovations in total joint replacement recently is the advent of the vitamin E infused polyethylene. Whilst not as exciting as the newer ceramic articulations or indeed as controversial as metal-on-metal, vitamin E infused polyethylene offers a tantalising compromise between improved wear characteristics and a reliable safety profile. There may also be another potential benefit. Researchers in Turin (Italy) assessed the effects that vitamin E infusion may have on bacterial adhesion (a key part of biofilm formation). The research team undertook a quantitative in vitro analysis using the most common bacterial species found in arthroplasty infection and measured the adhesion of biofilm producing strains to standard ultrahigh-molecular weight polyethylene (UHMWPE), vitamin E infused UHMWPE and cross linked UHMWPE using a standard laboratory analysis technique (sonication). The results were surprising. The research team established that both Staph. Aureus and E. Coli strains had a significantly lower adhesion to the vitamin E infused UHMWPE as compared with the standard polyethylenes.⁵ Given the catastrophic effects of infection, any potential to reduce the biofilm formation that is key to overcoming prosthetic infection must be seen as an extremely positive step. Vitamin E infused polyethylene may offer the killer combination of better wear characteristics and lower infection rates. Here at 360 we are watching developments with anticipation.