Clinical fracture of cross-linked UHMWPE acetabular liners

Furmanski, Jevan; Anderson, Martin; Bal, B. Sonny; Greenwald, A. Seth; Halley, David K.; Penenberg, Brad L.; Ries, Michael D.; Pruitt, Lisa A.

doi:10.1016/j.biomaterials.2009.07.013

Cited by 142 publications

(119 citation statements)

References 37 publications

Supporting

Mentioning

107

Contrasting

Unclassified

Order By: Relevance

“…These residual free radicals can migrate to the crystalline/amorphous interface and cause oxidation and reduction of UHMWPE elongation at break, tensile strength, fracture toughness and fatigue crack propagation resistance [33][34][35][36][37][38]. Therefore, to improve the oxidation resistance and the mechanical and fatigue strengths of cross-linked UHMWPE, antioxidant vitamin E is used to stabilise the radiation-induced free radicals [39][40][41][42].…”

Section: Vitamin-e-stabilised Uhmwpementioning

confidence: 99%

Wear Performance of UHMWPE and Reinforced UHMWPE Composites in Arthroplasty Applications: A Review

2015

View full text Add to dashboard Cite

Abstract:As the gold standard material for artificial joints, ultra-high-molecular-weight polyethylene (UHMWPE) generates wear debris when the material is used in arthroplasty applications. Due to the adverse reactions of UHMWPE wear debris with surrounding tissues, the life time of UHMWPE joints is often limited to 15-20 years. To improve the wear resistance and performance of the material, various attempts have been made in the past decades. This paper reviews existing improvements made to enhance its mechanical properties and wear resistance. They include using gamma irradiation to promote the cross-linked structure and to improve the wear resistance, blending vitamin E to protect the UHMWPE, filler incorporation to improve the mechanical and wear performance, and surface texturing to improve the lubrication condition and to reduce wear. Limitations of existing work and future studies are also identified.

show abstract

Section: Vitamin-e-stabilised Uhmwpementioning

confidence: 99%

Wear Performance of UHMWPE and Reinforced UHMWPE Composites in Arthroplasty Applications: A Review

2015

View full text Add to dashboard Cite

show abstract

“…Postirradiation thermal treatments [8,24,30], ie, annealing below the peak melting point and remelting above the melting point, have been used to reduce the levels of radicals generated during ionizing irradiation that otherwise would induce oxidation and embrittlement. Despite the clinical success of these materials for more than one decade, the decreased mechanical strength and fatigue resistance remain as concerns and may account for reports of early rim fractures of implants [14,15]. Moreover, in vivo oxidation of implants and in vitro oxidation of explants have recently been reported [6,7,28], even for remelted crosslinked UHMWPEs that show excellent oxidative stability during laboratory tests.…”

Section: Introductionmentioning

confidence: 99%

Natural Polyphenols Enhance Stability of Crosslinked UHMWPE for Joint Implants

Shen

Gao

Liu

2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Radiation-crosslinked UHMWPE has been used for joint implants since the 1990s. Postirradiation remelting enhances oxidative stability, but with some loss in strength and toughness. Vitamin E-stabilized crosslinked UHMWPE has shown improved strength and stability as compared with irradiated and remelted UHMWPE. With more active phenolic hydroxyl groups, natural polyphenols are widely used in the food and pharmaceutical industries as potent stabilizers and could be useful for oxidative stability in crosslinked UHMWPE. Questions/purposes We asked whether UHMWPE blended with polyphenols would (1) show higher oxidation resistance after radiation crosslinking; (2) preserve the mechanical properties of UHMWPE after accelerated aging; and (3) alter the wear resistance of radiation-crosslinked UHMWPE. Methods The polyphenols, gallic acid and dodecyl gallate, were blended with medical-grade UHMWPE followed by consolidation and electron beam irradiation at 100 kGy. Radiation-crosslinked virgin and vitamin E-blended UHMWPEs were used as reference materials. The UHMWPEs were aged at 120°C in air with oxidation levels analyzed by infrared spectroscopy. Tensile (n = 5 per group) and impact (n = 3 per group) properties before and after aging as per ASTM F2003 were evaluated. The wear rates were examined by pin-on-disc testing (n = 3 per group). The data were reported as mean ± SDs. Statistical analysis was performed by using Student's t-test for a two-tailed distribution with unequal variance for tensile and impact data obtained with n C 3. A significant difference is defined with p \ 0.05. Results The oxidation induction time of 100 kGy UHMWPE was prolonged to 144 hours with 0.05 wt% dodecyl gallate and 192 hours with 0.05 wt% gallic acid compared with 48 hours for 0.05 wt% vitamin E-blended UHMWPE. Accelerated aging of these polyphenol-blended UHMWPEs resulted in ultimate tensile strength of 50.4 ± 1.4 MPa and impact strength of 53 ± 5 kJ/m 2 for 100 kGy-irradiated UHMWPE with 0.05 wt% dodecyl gallate, for example, in comparison to 51.2 ± 0.7 MPa (p = 0.75) and 58 ± 5 kJ/m 2 (p = 0.29) before aging. The pin-on-disc wear rates of 100 kGy-irradiated UHMWPE with 0.05 wt% dodecyl gallate and 0.05 wt% gallic acid were 2.29 ± 0.31 and 1.65 ± 0.32 mg/million cycles, comparable to 1.68 ± 0.25 and 2.05 ± 0.22 mg/million cycles for 100 kGy-irradiated virgin and 0.05 wt% vitamin E-blended UHMWPE. Conclusions Based on the sample numbers tested in this study, polyphenols appear to effectively enhance the oxidation stability without altering the mechanical properties or pin-on-disc wear rate of radiation-crosslinked UHMWPE. Clinical Relevance Crosslinked UHMWPE with natural polyphenols with improved oxidative stability and low wear may find clinical application in joint implants.

show abstract

“…Although polyethylene wear and aseptic loosening were important reasons for failure of CPE inserts, these were not seen with the XLPE inserts (Table 2). We found no evidence of an increased propensity for rim fracturing or cracking with the XLPE liners, which has been reported in some previous studies [16,17,35]. We also specifically evaluated the damage scores in the peripheral zone of the liner that contacts with the locking mechanism in the shell.…”

Section: Discussionmentioning

confidence: 52%

Backside Wear Is Not Dependent on the Acetabular Socket Design in Crosslinked Polyethylene Liners

Bali

McCalden

Naudie

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Although it is understood that backside damage occurs in polyethylene acetabular liners, the effect of highly crosslinked polyethylene, which has completely replaced conventional polyethylene, has yet to be examined. Questions/purposes The purpose of this study was to answer the following questions: (1) With conventional polyethylene (CPE), did the acetabular design make a difference in backside wear? (2) Is there a difference in backside damage between CPE and crosslinked polyethylene (XLPE) liners? (3) With XLPE, is the difference in backside wear between designs still present? (4) Is there any difference in backside damage in various zones on backside of individual liners? Methods This single-institution retrieval analysis involved visual damage scoring on the backside of 233 polyethylene liners implanted between 2002 and 2011. The liners were retrieved from either polished/dovetail cups (PD) or roughened/wire cups (RW) made by two different manufacturers. The inserts were divided into four groups: PD-CPE (n = 105), PD-XLPE (n = 16), RW-CPE (n = 99), and RW-XLPE (n = 13). Aseptic loosening and polyethylene wear were the predominant reasons for revision of CPE liners, whereas instability and infection were the common reasons for revision of XLPE liners. The time in situ (TIS) was shorter for the XLPE liners as compared with the CPE liners (PD-CPE: 8.5 years [SD 4.4]; ; ; ). The backside of each liner was divided into five zones and graded initially from a scale of 0 to 3 for seven different damage modes by one observer. There was substantial interobserver (kappa 0.769) and intraobserver (0.736) reliability on repeat scoring. To compare the effects of crosslinking, a subset of the conventional polyethylene liners was matched to the crosslinked liners based on TIS,

show abstract

Clinical fracture of cross-linked UHMWPE acetabular liners

Cited by 142 publications

References 37 publications

Wear Performance of UHMWPE and Reinforced UHMWPE Composites in Arthroplasty Applications: A Review

Wear Performance of UHMWPE and Reinforced UHMWPE Composites in Arthroplasty Applications: A Review

Natural Polyphenols Enhance Stability of Crosslinked UHMWPE for Joint Implants

Backside Wear Is Not Dependent on the Acetabular Socket Design in Crosslinked Polyethylene Liners

Contact Info

Product

Resources

About