scholarly journals A Systematic Review and Meta-Analysis of the SuperPATH Approach in Hip Arthroplasty

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Yanzhi Ge ◽  
Zuxiang Chen ◽  
Qisong Chen ◽  
Yanbin Fu ◽  
Mengqiang Fan ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Postoperative Recovery ◽  
Harris Hip Score ◽  
Abduction Angle ◽  
Transfusion Rate ◽  
Invasive Approach ◽  
Dichotomous Variables

Objective. To compare the clinical and radiographic results of the supercapsular percutaneously assisted total hip (SuperPATH) approach and the conventional approach in hip arthroplasty. Design. Based on a prepublished protocol (PROSPERO: CRD42020177717), we searched PubMed, Embase, and Cochrane for relevant literatures up to January 30, 2021. The methodological qualities were assessed using the guidelines provided by the Cochrane Collaboration for Systematic Reviews. Randomized- or fixed-effect models were used to calculate the weighted mean difference (WMD) or odds ratio (OR), respectively, for continuous and dichotomous variables. Results. 6 articles were included in the study, and 526 patients were selected, which included 233 cases in the SuperPATH groups and 279 cases in the conventional groups, and 4 cases performed two surgeries in succession. The SuperPATH group demonstrated shorter incision length ( WMD = − 7.87 , 95% CI (−10.05, −5.69), P < 0.00001 ), decreased blood transfusion rate ( OR = 0.48 , 95% CI (0.25, 0.89), P = 0.02 ), decreased visual analogue scale (VAS) ( WMD = − 0.40 , 95% CI (−0.72, −0.08), P = 0.02 ), and higher Harris hip score (HHS) ( WMD = 1.98 , 95% CI (0.18, 3.77), P = 0.03 ) than the conventional group. However, there was no difference in VAS ( P = 0.14 ) and HHS ( P = 0.86 ) between the two groups 3 months later, nor in the acetabular abduction angle ( P = 0.32 ) in either group. Conclusions. SuperPATH, as a minimally invasive approach with its reduced tissue damage, quick postoperative recovery, and early rehabilitation, demonstrates the short-term advantages of hip arthroplasty. As the evidences in favor of the SuperPATH technique were limited in a small number of studies and short duration of follow-up, more research is required to further analyze its long-term effect.

scholarly journals A systematic review and meta-analysis of SuperPATH approach in hip arthroplasty

2020 ◽  
Author(s):  
Yanzhi Ge ◽  
Li Zhou ◽  
Zuxiang Chen ◽  
Ting Li ◽  
Peijian Tong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hip Arthroplasty ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Abduction Angle ◽  
Transfusion Rate ◽  
Invasive Approach ◽  
Significant Difference

Abstract Background: To compare the clinical and radiographic results of supercapsular percutaneously assisted total hip (SuperPATH) approach and conventional approach by systematic review and meta-analysis. Methods: Based on a pre-published protocol (PROSPERO CRD42020177717), we systematically retrieved databases from Pubmed, Embase, Cochrane and Web of Knowledge for relevant literatures from the earliest available date to May 30, 2020. No language restriction was applied. RevMan 5.3 software was used to perform the meta-analysis. The methodological qualities were assessed using the guidelines provided by the Cochrane Collaboration for Systematic Reviews. Two reviewers were independently extracted data from all eligible studies, including types of studies, participants, interventions, and outcomes. Randomized or fixed-effect models were used to calculate the weighted mean difference (WMD), odds ratio (OR) for continuous and dichotomous variables, respectively.Results: 6 articles were included in the study and 526 patients were selected, which was including 233 cases in the SuperPATH groups, 279 cases in the conventional groups and 4 cases performed two surgeries in succession. The SuperPATH group demonstrated shorter incision length (WMD = - 7.87, 95 % CI - 10.05 to - 5.69, P < 0.00001), decreased blood transfusion rate (OR = 0.48, 95 % CI 0.25 to 0.89, P = 0.02), decreased visual analogue scale (VAS) (WMD = -0.40, 95 % CI - 0.72 to - 0.08, P = 0.03) and higher Harris hip score (HHS) (WMD = 1.98, 95 % CI 0.18 to 3.77, P = 0.0002) than those in the conventional group. However, there was no difference in VAS and HHS between the two groups half a year later. There was no significant difference in the acetabular abduction angle (WMD = - 1.32, P = 0.32) in either group. Conclusions: SuperPATH minimally invasive approach with its reduced tissue damage, quick postoperative recovery and early rehabilitation demonstrates the short-term advantages of hip arthroplasty. However, the evidence for SuperPATH technique was limited in the number of studies and short duration of follow-up, so long-term results still need further analysis.

Effects of cinnamon supplementation on systolic and diastolic blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials

2021 ◽  
Author(s):  
Zeinab Yazdanpanah ◽  
Mandana Amiri ◽  
Azadeh Nadjarzadeh ◽  
Hadis Hooshmandi ◽  
Maryam Azadi-Yazdi
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Clinical Trials ◽  
Diastolic Blood Pressure ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Controlled Clinical Trials ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled

Introduction: Hypertension is a chronic condition that might lead to renal and cardiovascular diseases. The previous trials examining the effect of cinnamon supplementation on blood pressure have led to conflicting results. The present systematic review aimed to summarize the effect of cinnamon supplementation on blood pressure using a meta-analysis of published randomized controlled clinical trials. Methods: To identify the eligible articles, MEDLINE, SCOPUS, ISI Web of Science, and Google Scholar were searched from inception until September 2019 for relevant articles. The risk of bias assessment was performed using the Cochrane collaboration tool. A Random-effects model was applied to calculate the summary effects. Results: Totally, 11 trials with 686 participants were included in this systematic review and meta-analysis. The dose of cinnamon supplement consumption varied from 500 to 10000 mg/d. The meta-analysis revealed that cinnamon supplementation significantly decreases systolic blood pressure (SBP) [WMD (weighted mean difference)= -5.72 mmHg, 95% confidence interval (CI): -8.63 to -2.80; P<0.001, I2= 81.1)] and diastolic blood pressure (DBP) (WMD= -4.06 mmHg, 95% CI: -6.68 to -1.44; P= 0.002, I2 = 88.6). Subgroup analysis suggested no significant reduction of DBP in subjects with diabetes (WMD= -2.015 mmHg, 95% CI: -4.55 to 0.52; P= 0.12, I2 = 72.3) and prediabetes or metabolic syndrome (WMD= -4.8 mmHg, 95% CI: -10.06 to 0.44; P= 0.073, I2= 92.5). Conclusions: Cinnamon supplementation could be beneficial in lowering SBP and DBP in adults. Further studies with different doses are recommended to confirm the present findings.

scholarly journals The Efficacy and Safety of Fibrin Sealant Versus Tranexamic Acid Administration in Patients Undergoing Hip Arthroplasty: A Meta-analysis

2020 ◽  
Author(s):  
Fan Yong Yong ◽  
deng bo ◽  
Hong Hai Nan ◽  
Zhu Zhong
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Randomized Controlled Trials ◽  
Hip Arthroplasty ◽  
Fibrin Sealant ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Transfusion Rate ◽  
Efficacy And Safety ◽  
Randomized Controlled

Abstract PurposeThe efficacy and safety of topical fibrin sealant (FS) compared with tranexamic acid (TXA) to reduce blood loss after total hip arthroplasty (THA) is not clear. A meta-analysis was conducted to evaluate the efficacy and safety of topical FS versus topical or intravenous TXA for treatment of primary THA.MethodWe searched electronic databases, including PubMed, Embase, and the Cochrane Library to identify studies up to March 2020. The references included in articles were also checked for additional potentially-relevant studies. The language of publication was limited to English. The endpoints included the mean difference (MD) of blood loss, hemoglobin value, and odds ratios (ORs) of transfusion requirements and thrombotic events. Our meta-analysis was performed according to the Guidelines of the Cochrane Reviewer's Handbook and the PRISMA statement. The data of the included studies were analyzed using RevMan 5.3.ResultsA total of four studies (two randomized controlled trials and two non-randomized controlled trials) met the inclusion criteria. Our meta-analysis demonstrated that TXA administration led to significantly different outcomes in terms of transfusion rate (RD = -0.12, 95% CI (-0.23, -0.00), P = 0.05, I2 = 74%) and postoperative hemoglobin levels (WMD = -0.47, 95% CI (-0.74, -021), P = 0.0005, I2 = 3%) compared with topical application of FS in patients undergoing THA. No significant difference was seen in total calculated blood loss (WMD = -86.22, 95% CI (-99.13, -73.31), P < 0.00001, I2 = 96%) or complication rate (RR = 0.98, 95% CI (-99.13, -73.31), P = 0.45, I2 = 0%) between the two groups.ConclusionsTXA administration can effectively decrease the transfusion rate and result in higher postoperative hemoglobin levels without increasing the rate of infection.

Stationary cycling exercise for knee osteoarthritis: A systematic review and meta-analysis

2020 ◽  
pp. 026921552097179
Author(s):  
Lijiang Luan ◽  
Jaquelin Bousie ◽  
Adrian Pranata ◽  
Roger Adams ◽  
Jia Han
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Sport Performance ◽  
Cochrane Library ◽  
Cycling Exercise ◽  
Random Effects Models

Objective: To evaluate effects of stationary cycling exercise on pain, function and stiffness in individuals with knee osteoarthritis. Data sources: Systematic search conducted in seven databases (PubMed, Embase, Cochrane Library, Web of Science, EBSCO, PEDro, and CNKI) from inception to September 2020. Review methods: Included studies were randomized-controlled trials involving stationary cycling exercise conducted on individuals with knee osteoarthritis. End-trial weighted mean difference (WMD) and 95% confidence interval (CI) were analyzed, and random-effects models were used. Methodological quality and risk bias were assessed by using the Physiotherapy Evidence Database scale and Cochrane Collaboration tool, respectively. Results: Eleven studies with 724 participants were found, of which the final meta-analysis was performed with eight. Compared to a control (no exercise), stationary cycling exercise resulted in reduced pain (WMD 12.86, 95% CI 6.90–18.81) and improved sport performance (WMD 8.06, 95% CI 0.92–15.20); although most of the meta-analysis results were statistically significant, improvements in stiffness (WMD 11.47, 95% CI 4.69–18.25), function (WMD 8.28, 95% CI 2.44–14.11), symptoms (WMD 4.15, 95% CI −1.87 to 10.18), daily living (WMD 6.43, 95% CI 3.19 to 9.66) and quality of life (WMD 0.99, 95% CI −4.27 to 6.25) for individuals with knee osteoarthritis were not greater than the minimal clinically important difference values for each of these outcome measures. Conclusions: Stationary cycling exercise relieves pain and improves sport function in individuals with knee osteoarthritis, but may not be as clinically effective for improving stiffness, daily activity, and quality of life.

scholarly journals Transosseous versus transmuscular repair of the posterior soft tissue in primary hip arthroplasty: a meta-analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Changjiao Sun ◽  
Xiaofei Zhang ◽  
Qi Ma ◽  
Ruiyong Du ◽  
Xu Cai ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Dislocation Rate ◽  
Harris Hip Score ◽  
Cochrane Library ◽  
Vas Score ◽  
Transosseous Repair ◽  
Posterior Soft Tissue

Abstract Background During the posterior approach, it has been shown that a significant reduction in dislocation rate can be achieved with the repair of the posterior soft tissue. However, no consensus exists about the best way to perform this repair. This review aimed to compare the transosseous with transmuscular repair of the posterior soft tissue in total hip arthroplasty (THA). Methods We conducted a meta-analysis to identify studies involving transosseous versus transmuscular repair of the posterior soft tissue in THA in electronic databases, including Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, CNKI, VIP, Wanfang database, up to July 2020. Finally, we identified 1417 patients (1481 hips) assessed in seven studies. Results Compared with transmuscular repair, transosseous repair resulted in less incidence of dislocation (P = 0.003), less blood loss during operation (P < 0.00001) and lower VAS score within 3 months (P = 0.02). There were no significant differences in terms of trochanteric fracture rate (P = 0.56), Harris hip score at 3 months (P = 0.35) and 6 months (P = 0.89), VAS score within 6 months (P = 0.53), and operation time (P = 0.70) between two groups. Conclusion The lower dislocation rate, less blood loss, and lower VAS scores after operation supported transosseous repair's superiority to transmuscular repair. Besides, no additional medical cost and operating time were associated with transosseous repair compared with transmuscular repair. Hence, we recommend that transosseous repair be chosen first by orthopedists when performing reconstruction of the posterior soft tissue in THA via a posterolateral approach. Given the relevant possible biases in our meta-analysis, we required more adequately powered and better-designed RCT studies with long-term follow-up to reach a firmer conclusion.

scholarly journals The Efficacy and Aafety of Fibrin Sealant Versus Tranexamic Acid Administration in Patients Undergoing Hip Arthroplasty: A Meta-Analysis.

2020 ◽  
Author(s):  
Yong Yong Fan ◽  
Hai Nan Hong ◽  
Bo Deng ◽  
Zhong Zhu
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Randomized Controlled Trials ◽  
Hip Arthroplasty ◽  
Fibrin Sealant ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Transfusion Rate ◽  
Efficacy And Safety ◽  
Randomized Controlled

Abstract Purpose: The efficacy and safety of topical fibrin sealant (FS) compared with tranexamic acid (TXA) to reduce blood loss after total hip arthroplasty (THA) is not clear. A meta-analysis was conducted to evaluate the efficacy and safety of topical FS versus topical or intravenous TXA for treatment of Method: We searched electronic databases, including PubMed, EMBASE, and the Cochrane Library to identify studies up to March 2020. The references included in articles were also checked for additional potentially-relevant studies. The language of publication was limited to English. The endpoints included the mean difference (MD) of blood loss, hemoglobin value, and odds ratios (ORs) of transfusion requirements and thrombotic events. Our meta-analysis was performed according to the Guidelines of the Cochrane Reviewer's Handbook and the PRISMA statement. The data of the included studies were analyzed using RevMan 5.3.Results: A total of four studies (two randomized controlled trials and two non-randomized controlled trials) met the inclusion criteria. Our meta-analysis demonstrated that TXA administration led to significantly different outcomes in terms of transfusion rate (RD = -0.12, 95% CI (-0.23, -0.00), P = 0.05, I2 = 74%) and postoperative hemoglobin levels (WMD = -0.47, 95% CI (-0.74, -021), P = 0.0005, I2 = 3%) compared with topical application of FS in patients undergoing THA. No significant difference was seen in total calculated blood loss (WMD = -86.22, 95% CI (-99.13, -73.31), P < 0.00001, I2 = 96%) or complication rate (RR = 0.98, 95% CI (-99.13, -73.31), P = 0.45, I2 = 0%) between the two groups.Conclusions: TXA administration can effectively decrease the transfusion rate and result in higher postoperative hemoglobin levels without increasing the rate of infection.

scholarly journals Updated Evaluation of Laparoscopic vs. Open Appendicectomy During Pregnancy: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jia Zhang ◽  
Miye Wang ◽  
Zechang Xin ◽  
Ping Li ◽  
Qingbo Feng
Keyword(s):  
Systematic Review ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Fetal Loss ◽  
Mean Difference ◽  
Perioperative Outcomes ◽  
Cochrane Central Register ◽  
Open Appendicectomy ◽  
Advantages And Disadvantages ◽  
Dichotomous Variables

To explore the updated evaluation about the obstetrical and perioperative outcomes of laparoscopic appendicectomy (LA) for pregnancy appendicitis compared with open appendicectomy (OA). Two reviewers independently searched the PubMed, the Cochrane Central Register of Controlled Trials, EMBASE, and Web of Science databases to screen eligible studies up to December 2020. Only clinical researches, no &lt; 10 cases for LA and OA group were included. Twenty retrospective studies with 7,248 pregnant women, evaluating LA and OA in surgical and obstetrical outcomes, were included. The weighted mean difference (WMD) with 95% CI and odds ratio (OR) was used to compare continuous and dichotomous variables. It seems LA was connected with significantly shorter hospital time and lower wound infection [mean difference (MD), −0.57 days; 95% CI, −0.96 to −0.18; p = 0.004 and OR, 0.34; 95% CI, 0.18 to 0.62; p = 0.0005, respectively]. The incidence of fetal loss after LA was higher than OA (OR,1.93; 95% CI, 1.39–2.69; p &lt; 0.0001). It was almost similar in the rate of preterm delivery (OR, 0.80; 95% CI, 0.48 to 1.34; p = 0.40) and other perioperative and obstetrical complications (p &gt; 0.05). Our results indicated that the occurrence of fetal loss after LA should not be ignored. Caution, skillful operation, and thoroughly informed consent about the advantages and disadvantages of laparoscopy are necessary.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier: CRD42021233150.

Duhamel and Transanal Endorectal Pull-throughs for Hirschsprung' Disease: A Systematic Review and Meta-analysis

2017 ◽  
Vol 28 (01) ◽  
pp. 081-088 ◽  
Author(s):  
Hiromu Miyake ◽  
Alison Hock ◽  
Yuhki Koike ◽  
Chen Yong ◽  
Carol Lee ◽  
...  
Keyword(s):  
Anastomotic Stricture ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Hirschsprung Disease ◽  
Continuous Variables ◽  
Postoperative Constipation ◽  
Dichotomous Variables ◽  
Pull Through

Aim The Duhamel pull-through and transanal endorectal pull-through (TEPT) are commonly used for the treatment of Hirschsprung's disease (HD). To date, there has been no meta-analysis evaluating postoperative outcomes following Duhamel pull-through and TEPT. The purpose of this meta-analysis was to compare patient outcome after Duhamel pull-through and TEPT for HD. Materials and Methods Original articles published between 1998 and 2016 were identified using the MEDLINE database. Studies comparing Duhamel pull-through and TEPT were included. Outcomes evaluated included incidence of postoperative constipation, incontinence/soiling, enterocolitis, anastomotic stricture, and leak. We analyzed dichotomous variables by estimating odds ratios (OR) with 95% confidence intervals (CI) and continuous variables using the weighted mean difference with 95% CI. The meta-analysis was done using RevMan 5.3. Result There were no randomized controlled trials. Seven observational clinical studies were included, comprising 260 cases of Duhamel pull-through and 170 cases of TEPT. Anastomotic stricture (OR = 0.10; 95%CI 0.02–0.48; p = 0.004) was lower following Duhamel pull-through than TEPT. There were no significant differences in the incidence of postoperative incontinence/soiling and anastomotic leak. After TEPT, postoperative constipation seems to be lower and enterocolitis higher compared with those after Duhamel pull-through; however, these differences are not significant when the follow-up period is equal between groups. Conclusion The Duhamel pull-through seems to be associated with lower incidence of anastomotic stricture compared with TEPT. The effects of the two analyzed operative techniques on constipation and enterocolitis remain unclear. The quality of evidence supporting the above findings is suboptimal, indicating the need for prospective studies.

scholarly journals Clinical and radiological outcomes of total hip arthroplasty in patients affected by Paget’s disease: a combined registry and single-institution retrospective observational study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alberto Di Martino ◽  
Maria Antonietta Rita Coppola ◽  
Barbara Bordini ◽  
Niccolò Stefanini ◽  
Giuseppe Geraci ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Paget’S Disease ◽  
Paget's Disease ◽  
Harris Hip Score ◽  
Autologous Blood Transfusion ◽  
Transfusion Rate ◽  
Safe Procedure ◽  
Single Institution ◽  
Total Hip

Abstract Background Total hip arthroplasty (THA) in patients with Paget’s disease can be associated with technical difficulties related to deformities and altered mechanical bone properties, and hypervascularity leads to significative intra-operative bleeding. The purpose of this registry and single-institution study was to investigate overall survival and causes of failure of THA in pagetic patients, together with an analysis of the clinical and radiological complications. Material and methods Registry-based survival and complication analysis, type of fixation, intra- and post-operative complications, clinical (pharmacological history, blood transfusions, Harris hip score [HHS]) and radiographic (cup orientation, stem axial alignment, osteolysis around the cup and the stem and heterotopic ossification [HO]) data were reviewed. Results In total, 66 patients (27 males and 39 females, mean age at surgery 71.1 years for males and 74.8 years for female) from the registry study presented a 10-year survival of 89.5%. In the institutional study, involving 26 patients (14 males and 12 females, 69 years average) and 29 THAs, hip function improved significantly. Average cup orientation was 40.5°, while varus stem alignment was 13.8%. In total, 52% of hips had heterotopic ossifications. Peri-acetabular osteolysis was in 13.8% of implants and in 45% of hips was found around the stem. Allogenic and autologous blood transfusion rate were 68.2% and 31.8%, respectively, with an average transfusion of 2 units of blood (range 1–6 units). HHS improved by an average of 34 points, with excellent result in 64.3% of patients. Two implants failed, one due to traumatic ceramic head fracture 64 months after surgery, and one due to mobilization of the cup on the second post-operative day. Conclusion THA surgery in Paget’s patients is a safe procedure, and implant survival is only partly affected by bone remodelling and choice of fixation. The post-operative functional outcome is largely similar to that of other patients. Bleeding-related complications are the main complications; a careful pharmacological strategy should be recommended to decrease the risk of transfusions and of HO development. Level of evidence Level III

scholarly journals Vitamin E-Enhanced Liners in Primary Total Hip Arthroplasty: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Qian-Yue Cheng ◽  
Bin-Fei Zhang ◽  
Peng-Fei Wen ◽  
Jun Wang ◽  
Lin-Jie Hao ◽  
...  
Keyword(s):  
Vitamin E ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Rate ◽  
Meta Analysis ◽  
Harris Hip Score ◽  
Head Penetration ◽  
Total Hip ◽  
Femoral Head Penetration

Objective. Adding vitamin E to highly cross-linked polyethylene liners is frequently performed in clinical practice, aiming at reducing liner wear, increasing liner survival, and delaying revision surgery. This study is aimed at evaluating the revision rate, total femoral head penetration, and postoperative clinical function of highly cross-linked polyethylene liners with and without vitamin E in total hip arthroplasty. Methods. We conducted a systematic literature search to identify the use of highly cross-linked vitamin E liners compared to other liners in patients who received total hip arthroplasty (THA) before April 2021. The study quality assessment and data collection were conducted by two independent reviewers. Studies were artificially grouped, and vitamin E-enhanced liners (VE-PE) were compared with vitamin E-free liners (non-VE-PE). Analyses were executed using Review Manager version 5.4.1. Results. From the preliminary screening of 568 studies, fourteen studies met the research criteria. Compared to non-VE-PE, using VE-PE reduced the all-cause revision rate ( odds   ratio = 0.54 ; 95% confidence interval (CI) 0.40, 0.73; P < 0.0001 ). The total femoral head penetration of the VE-PE was lower than that of the non-VE-PE ( mean   difference = − 0.10 ; 95% CI -0.17, -0.03; P = 0.007 ). However, there was no difference in clinical function, including the Harris Hip Score and EuroQol Five-Dimension Questionnaire scores. Conclusion. Compared to the liners without vitamin E, the addition of vitamin E to liners could reduce the all-cause revision rate by approximately 46% in the short-term follow-up. In addition, even though addition of vitamin E could also slow down femoral head penetration, there is no contribution to clinical function.

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