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January 25, 2026Acta OrthopaedicaOpen Access

Association of antioxidant-added highly cross-linked polyethylene on revision risk: a registry-based study of 198,073 total hip replacements from the Australian Orthopaedic Association National Joint Replacement Registry between 2014 and 2023

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Authors

DLDavid LieuHealth NetDCDavid G. CampbellWakefield Orthopaedic ClinicPDPeiyao DuSouth Australian Health and Medical Research Institute

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Implication

Registry-based study compares revision rates of hip replacements with antioxidant and standard polyethylenes, suggesting improved outcomes for antioxidant use.

Key Points

  • To compare revision rates of total hip replacements using XLPE with and without antioxidants.
  • Analyzed data from the Australian Orthopaedic Association National Joint Replacement Registry from 2014-2023.
  • Compared cementless acetabular components with XLPE and AOXLPE inserts.
  • Measured all-cause revision rates using Kaplan–Meier and Cox models.
  • 198,073 total hip replacements analyzed, with 35,309 using AOXLPE inserts.
  • 769 revisions for AOXLPE vs. 4,327 revisions for XLPE inserts.
  • The AOXLPE group showed a lower revision rate after 3 years (HR 0.64).

Cite This Study

Lieu et al. (2026) studied this question.

synapsesocial.com/papers/6975b350feba4585c2d6ec35https://doi.org/10.2340/17453674.2025.45181
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effects of Vitamin E-Stabilized Ultra High Molecular Weight Polyethylene on Oxidative Stress Response and Osteoimmunological Response in Human Osteoblast2019 · 16 citations
  2. 2Metal-on-conventional Polyethylene Total Hip Arthroplasty Bearing Surfaces Have a Higher Risk of Revision Than Metal-on-highly Crosslinked Polyethylene: Results From a US Registry2015 · 55 citations
  3. 3Vitamin E-added Highly Cross-Linked Polyethylene Decreases the Risk of Osteolysis in an In Vivo Arthroplasty Model2023 · 3 citations
  4. 4Vitamin E‐Enhanced Liners in Primary Total Hip Arthroplasty: A Systematic Review and Meta‐Analysis2021 · 13 citations