Mechanisms of Crosslinking, Oxidative Degradation and Stabilization of UHMWPE

Costa, Luigi; Bracco, Pierangiola

doi:10.1016/b978-0-12-374721-1.00021-3

Cited by 29 publications

(38 citation statements)

References 64 publications

(103 reference statements)

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“…Both are safe for human consumption in prepared food [32], but their intra-articular effects are not known. Simulated manufacturing conditions showed no detectable elution from vitamin E-diffused UHMWPE [20,59], but there was measurable elution in water at 40°C. The concentration profile became uniform at approximately 0.7 wt% at 3 years, suggesting saturation at this concentration at 40°C.…”

Section: Discussionmentioning

confidence: 95%

“…Due to radiolytic bond scission, free radicals are produced in irradiated UHMWPE [15,18,20,30,38], which react with oxygen and trigger the oxidation cascade [2, 16, 17, 20, 22, 25-27, 54, 69] ( Fig. 2A, Reactions 1-4).…”

Section: Discussionmentioning

confidence: 99%

“…Oxidation is accompanied by chain scissioning, deteriorating its mechanical properties [19,24,43]. The stabilization mechanism of a-tocopherol in UHMWPE has been studied [11,20,23,85]. It is believed a-tocopherol can stabilize peroxy radicals formed by oxidation and can also directly react with alkyl macroradicals ( Fig.…”

Section: Discussionmentioning

confidence: 99%

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Vitamin E-stabilized UHMWPE for Total Joint Implants: A Review

Bracco

Oral

2011

Clinical Orthopaedics &Amp; Related Research

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256

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Background Osteolysis due to wear of UHMWPE limits the longevity of joint arthroplasty. Oxidative degradation of UHMWPE gamma-sterilized in air increases its wear while decreasing mechanical strength. Vitamin E stabilization of UHMWPE was proposed to improve oxidation resistance while maintaining wear resistance and fatigue strength. Questions/purposes We reviewed the preclinical research on the development and testing of vitamin E-stabilized UHMWPE with the following questions in mind: (1) What is the rationale behind protecting irradiated UHMWPE against oxidation by vitamin E? (2) What are the effects of vitamin E on the microstructure, tribologic, and mechanical properties of irradiated UHMWPE? (3) Is vitamin E expected to affect the periprosthetic tissue negatively? Methods We performed searches in PubMed, Scopus, and Science Citation Index to review the development of vitamin E-stabilized UHMWPEs and their feasibility as clinical implants.Results The rationale for using vitamin E in UHMWPE was twofold: improving oxidation resistance of irradiated UHMWPEs and fatigue strength of irradiated UHMWPEs with an alternative to postirradiation melting. Vitamin E-stabilized UHMWPE showed oxidation resistance superior to that of irradiated UHMWPEs with detectable residual free radicals. It showed equivalent wear and improved mechanical strength compared to irradiated and melted UHMWPE. The biocompatibility was confirmed by simulating elution, if any, of the antioxidant from implants.Conclusions Vitamin E-stabilized UHMWPE offers a joint arthroplasty technology with good mechanical, wear, and oxidation properties. Clinical Relevance Vitamin E-stabilized, irradiated UHMWPEs were recently introduced clinically. The rationale behind using vitamin E and in vitro tests comparing its performance to older materials are of great interest for improving longevity of joint arthroplasties.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Vitamin E-stabilized UHMWPE for Total Joint Implants: A Review

Bracco

Oral

2011

Clinical Orthopaedics &Amp; Related Research

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256

162

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“…To increase the abrasion resistance, crosslinked UHMWPE (X-PE) appeared on the market in the late 1990s [9][10][11]15]. Crosslinking of a polymer is the linking of two or more molecular chains by means of chemical covalent bonds: macro radical species, formed by treatment with high energy, react with vinyl double bonds, linking the polymer chains with a C-C stable chemical bond and giving Y-crosslink.…”

Section: Crosslinked Uhmwpementioning

confidence: 99%

“…As already pointed out, PE is easily subject to oxidation, which strongly compromises their mechanical properties. The oxidation is basically due to E.M. Brach del Prever et al the reaction between macroradicals and oxygen diffused into the polymer from the surrounding atmosphere; Vitamin E decreases the macro alkyl radicals available to react with the oxygen and thus to a significant slowdown of the oxidative cascade [9][10][11][15][16][17]. Unfortunately, a decreased number of available alkyl radicals is also responsible for a lower efficiency of crosslinking at the same radiation dose, but a correct vitamin E concentration and radiation dose determine an oxidatively stable UHMWPE, without the need of a further thermal treatment, with enough crosslink density and consequent resistance to abrasion.…”

Section: Vitamin E Stabilised Uhmwpementioning

confidence: 99%

Biomaterials for Total Joint Replacements

Prever

Costa

Piconi

et al. 2016

Biomechanics and Biomaterials in Orthopedics

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Ultra High Molecular Weight Polyethylene and its Reinforcement with Carbon Nanotubes in Medical Devices

Guedes

Kanagaraj

Sreekanth

et al. 2015

Polyethylene‐Based Blends, Composites and Nanocomposites

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This chapter discusses the advantages and complexities of ultra high molecular weight polyethylene (UHMWPE) when used as a bearing material for total joint arthroplasty (TJA) and total knee arthroplasty (TKA). The UHMWPE internal structure and its mechanical response depend strongly on a diversity of factors that include radiation crosslinking, fiber reinforcement, and the addition of antioxidants such as Vitamin E or Vitamin C. All these manufacturing procedures induce morphological changes and simultaneously alter the mechanical properties of UHMWPE. The importance of UHMWPE on arthroplasty, including the advantages, the limitations and the strategies devised to overcome the known drawbacks are discussed in the first section. The following sections revise and discuss the biocompatibility, the manufacturing processes, the tribological behaviour, the aging by oxidation and irradiation of UHMWPE and UHMWPE-CNT nanocomposites. The last section analyses the viscoelastic behavior of UHMWPE and its implications on the long-term survival of total joint arthroplasty.

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Mechanisms of Crosslinking, Oxidative Degradation and Stabilization of UHMWPE

Cited by 29 publications

References 64 publications

Vitamin E-stabilized UHMWPE for Total Joint Implants: A Review

Vitamin E-stabilized UHMWPE for Total Joint Implants: A Review

Biomaterials for Total Joint Replacements

Ultra High Molecular Weight Polyethylene and its Reinforcement with Carbon Nanotubes in Medical Devices

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