Vitamin E total knee replacement performed at Tri-City Medical Center

Dr. James Helgager, an experienced orthopedic surgeon, implanted the first vitamin E Total Knee Replacement in San Diego County on July 31 at Tri-City Medical Center in Oceanside. Helgager is the Medical Director of Joint Replacement for the Orthopaedic & Spine Institute at Tri-City Medical Center. He has been practicing medicine for more than three decades and has performed thousands of total knee replacements.

E-plusTM, manufactured by Vista-based DJO Surgical, a DJO Global Company, is an innovative polyethylene blended with vitamin E, a natural anti-oxidant. This insert has been created for the 3DKneeTM, a knee replacement designed to improve strength, stability, and flexion in recipients.

Polyethylene wear continues to be a weak point in total knee replacement. Vitamin E improves the material’s tensile strength while preventing polyethylene degenerating oxidation. This will help the material hold up to the expectations of today’s active patient. E-plus is the first blended vitamin e polyethylene, meaning that the vitamin E is blended right into the resin and is homogeneous throughout the insert component.

The 3DKnee Data Driven Design is based on over a decade of research into total knee kinematics and over 30,000 have been implanted world-wide. E-plus now adds a new level of performance to 3DKnee total knee replacement. "The cause of Total Knee Replacement failure is polyethylene wear and DJO's E-plus polyethylene bearing surface is very promising in addressing this issue,” said Dr. Helgager. “Long-term studies will prove its longevity and performance benefits to the patient."

With the aging baby boomer population, orthopedic procedures are growing exponentially. Active people are requiring joint replacements at a younger age and are living longer. It is becoming increasingly important to use strong, lasting materials in joint replacements.

Total knee replacement is conducted under general or local anesthesia; and generally takes about 1 to 1 ½ hours to complete. Most patients will be placing weight on their new knee the day of or the day after surgery.


  1. Honest Orthopedist Honest Orthopedist United States says:

    Another triumph of marketing over science. There is no evidence that shows the vitamin E poly has any better wear properties than any other cross-linked polyethylene.  Knee replacements fail today because of stiffness, infection, instability, and pain, not because of polyethylene wear.   It is actually incredibly uncommon  that a knee replacement today fails because of polyethylene wear.

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