Does Vitamin E–Stabilized Ultrahigh-Molecular-Weight Polyethylene Address Concerns of Cross-Linked Polyethylene in Total Knee Arthroplasty?

Haider, Hani; Weisenburger, Joel; Kurtz, Steven M.; Rimnac, Clare M.; Freedman, Jordan; Schroeder, David; Garvin, Kevin L.

doi:10.1016/j.arth.2011.03.024

Cited by 83 publications

(67 citation statements)

References 37 publications

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“…These more lax ligament characteristics are comparable to ligament characteristics defined in this study, despite both approaches (ISO and this study) replicating different ligament conditions. However, only limited published data is available for wear testing according to the newly introduced ISO standard [32, 47]. Haider et al [47] reported a high wear rate of 19.88 mg/10 6 cycles for a posterior-stabilized design without reporting the resulting kinematics.…”

Section: Discussionmentioning

confidence: 99%

“…However, only limited published data is available for wear testing according to the newly introduced ISO standard [32, 47]. Haider et al [47] reported a high wear rate of 19.88 mg/10 6 cycles for a posterior-stabilized design without reporting the resulting kinematics. Recently, Grupp et al [32] tested the wear behavior of a posterior-stabilized knee design, comparing the old ISO standard to the recently introduced one.…”

Section: Discussionmentioning

confidence: 99%

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Wear Behavior of an Unstable Knee: Stabilization via Implant Design?

Reinders

Sonntag

Kretzer

2014

BioMed Research International

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Background. Wear-related failures and instabilities are frequent failure mechanisms of total knee replacements. High-conforming designs may provide additional stability for the joint. This study analyzes the effects of a ligamentous insufficiency on the stability and the wear behavior of a high-conforming knee design. Methods. Two simulator wear tests were performed on a high-conforming total knee replacement design. In the first, a ligamentous-stable knee replacement with a sacrificed anterior cruciate ligament was simulated. In the second, a ligamentous-unstable knee with additionally insufficient posterior cruciate ligament and medial collateral ligament was simulated. Wear was determined gravimetrically and wear particles were analyzed. Implant kinematics was recorded during simulation. Results. Significantly higher wear rates (P ≤ 0.001) were observed for the unstable knee (14.58 ± 0.56 mg/106 cycles) compared to the stable knee (7.97 ± 0.87 mg/106 cycles). A higher number of wear particles with only small differences in wear particle characteristics were observed. Under unstable knee conditions, kinematics increased significantly for translations and rotations (P ≤ 0.01). This increase was mainly attributed to higher tibial posterior translation and internal rotations. Conclusion. Higher kinematics under unstable test conditions is a result of insufficient stabilization via implant design. Due to the higher kinematics, increased wear was observed in this study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Wear Behavior of an Unstable Knee: Stabilization via Implant Design?

Reinders

Sonntag

Kretzer

2014

BioMed Research International

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“…However, the UHMWPE has a risk of oxidation during irradiation and in storage until vitamin E is incorporated. The vitamin E-stabilised cross-linked UHMWPE, which is produced using this method, has been clinically used since 2007 [44,45,[47][48][49].…”

Section: Methods Of Vitamin E Blendingmentioning

confidence: 99%

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

2015

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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.

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“…The most common failure mechanisms of prosthetic knee joints include mechanical loosening and instability, often resulting from osteolysis (“weakening of the bone”), which is driven by a biological response to polyethylene wear particles that causes bone resorption [10]. Manufacturers of prosthetic knee joints combat implant wear by attempting to improve the mechanical properties of the polyethylene tibial insert [11] and by increasing the smoothness of the bearing surfaces, witnessed by the increased interest in ceramic prosthetic knee joints [12-14]. However, the longevity of these man-made bearing surfaces still does not replicate, or even approach that of natural articular cartilage [15].…”

Section: Introductionmentioning

confidence: 99%

Designing prosthetic knee joints with bio-inspired bearing surfaces

Qiu

Chyr

Sanders

et al. 2014

Tribology International

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It has long been known that articular cartilage exhibits a surface microtexture with shallow indentations. By contrast, prosthetic joints consist of ultra-smooth bearing surfaces, the longevity of which does not reach that of natural cartilage. We show that adding a microtexture to the smooth femoral component of a prosthetic knee joint reduces friction by increasing the lubricant film thickness between the bearing surfaces of the knee. We have implemented an elastohydrodynamic lubrication model to optimize the geometry of the microtexture, while taking into account the deformation of the polyethylene tibial insert. We have manufactured several microtexture designs on a surrogate femoral component, and experimentally demonstrate that the microtexture reduces friction between the surrogate femoral component and tibial insert.

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Does Vitamin E–Stabilized Ultrahigh-Molecular-Weight Polyethylene Address Concerns of Cross-Linked Polyethylene in Total Knee Arthroplasty?

Cited by 83 publications

References 37 publications

Wear Behavior of an Unstable Knee: Stabilization via Implant Design?

Wear Behavior of an Unstable Knee: Stabilization via Implant Design?

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

Designing prosthetic knee joints with bio-inspired bearing surfaces

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