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Early Fracture of a Vitamin-E-Infused, Highly Cross-Linked Polyethylene Liner After Total Hip Arthroplasty: A Case Report

Case:A vitamin-E-infused, highly cross-linked ultra-high molecular weight polyethylene (HXLPE) acetabular liner fractured without trauma less than twelve months after its implantation in a seventy-one-year-old woman. Conclusion:The remelting process utilized in the production of many commercially available HXLPE acetabular liners causes an immediate reduction in the fracture toughness of the material; however, it provides the benefit of oxidative stability, which prevents the loss of beneficial mechanical properties over time. Vitamin-E-infused HXLPE avoids the immediate decrease in fracture toughness by avoiding the remelting process. The case of our patient demonstrates that this material still can experience catastrophic failure despite acceptable component positioning.