FOI: First TSA With e+

Florida Orthopaedic Institute has announced the first ever total shoulder arthroplasty with the use of e+, a vitamin E infused polyethylene component. Mark Frankle, M.D., director of the shoulder and elbow fellowship at Florida Orthopaedic Institute, performed the surgery at Tampa General Hospital. The patient is a 71-year-old retired postal worker and retired U.S. Navy jet engine repairman. e+, which prolongs the life of total joint replacement and received FDA approval in 2013, was developed by DJO Surgical. Testing showed a 57% reduction in wear, compared to a standard component.

While a number of products on the market are infused with vitamin E, (the vitamin E is added after it is manufacturing), e+ is blended directly into the resin for a more uniform distribution of the vitamin E within the polyethylene. This helps the material retain improved mechanical and wear properties throughout the product.

Dr. Frankle told OTW, “We anticipate using e+ in all total shoulder surgeries for our active and young patients. What makes e+ effective is that the plastic part of the replacement is more resistant to wear, which is why it’s an ideal product for patients who have a high activity level. We have scheduled 12 total shoulder surgeries with the use of e+ in April alone. Dr. Mark Mighell, who specializes in shoulder and elbow surgery at Florida Orthopaedic Institute, will also perform shoulder replacement surgery with e+.”

Bryan Monroe, Senior Vice President, General Manager, DJO Surgical, told OTW, “A lot of hard work went into launching many products at this year’s AAOS [American Academy of Orthopaedic Surgeons]. As with all projects, there were hurdles in the development process, but we are thrilled with the final outcome of each of the new products. We are excited to expand our e+ blended vitamin E polyethylene into our shoulder line. e+ has been a part of our knee line for over a year, and the initial results have been fantastic. We are confident that e+ will benefit patients that receive the device. e+ differs from other vitamin E polyethylene products in the way that the vitamin E is introduced into the polyethylene material. While a number of products on the market are ‘infused’ with vitamin E, meaning the vitamin E is added to the part after it is manufactured, e+ is blended directly into the resin for a more uniform distribution of the vitamin E within the polyethylene. This should help the material retain improved mechanical and wear properties throughout the part. Additionally, DJO Surgical has incorporated this technology into additional product offerings to be released later in 2013.”