Three Year RSA Evaluation of Vitamin E Diffused Highly Cross-linked Polyethylene Liners and Cup Stability

Sillesen, Nanna H.; Greene, Meridith E.; Nebergall, Audrey; Nielsen, Poul; Laursen, Mogens Berg; Troelsen, Anders; Malchau, Henrik

doi:10.1016/j.arth.2015.02.018

Cited by 32 publications

(17 citation statements)

References 15 publications

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“…Vitamin Ediffused, crosslinked UHMWPE has been in clinical use since 2007 with excellent wear resistance and comparable clinical performance to previously used highly crosslinked UHMWPEs. 18,19 Recent reports of oxidation in vivo 20 even in irradiated and melted UHMWPEs without detectable free radicals at the time of implantation have suggested additional oxidation initiation mechanisms in vivo. In vitro oxidation test development has supported this hypothesis by showing that the absorption of synovial fluid lipids and/or cyclic loading can initiate oxidation in irradiated and melted UHMWPEs.…”

Section: Introductionmentioning

confidence: 99%

Peroxide cross‐linked UHMWPE blended with vitamin E

et al. 2016

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Radiation crosslinked ultrahigh molecular weight polyethylene (UHMWPE) is the bearing surface material most commonly used in total joint arthroplasty because of its excellent wear resistance. Crosslinking agents such as peroxides can also effectively increase wear resistance but peroxide crosslinked UHMWPE has low oxidative stability. We hypothesized that the addition of an antioxidant to peroxide crosslinked UHMWPE could improve its oxidation resistance and result in mechanical, tribological, and oxidative properties equivalent to currently utilized radiation crosslinked UHMWPEs. Various vitamin E (0.1-1.0 wt % and peroxide concentration (0.5-1.5 wt %) combinations were studied to investigate changes in crosslink density, wear rate, mechanical properties, and oxidative stability in comparison to radiation crosslinked UHMWPE. Peroxide crosslinking was more efficient as compared to radiation crosslinking in the presence of vitamin E with the former resulting in lower wear rate with vitamin E concentrations above 0.3 wt %. The tensile mechanical properties were comparable to and the impact strength was higher than those of the clinically relevant radiation crosslinked controls. We also determined that gamma sterilization of peroxide crosslinked vitamin E blends improved wear resistance further. In summary, peroxide crosslinking of vitamin E-blended UHMWPE may provide a feasible and economical alternative to radiation for achieving clinically relevant properties for total joint implants using UHMWPE. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1379-1389, 2017.

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Section: Introductionmentioning

confidence: 99%

Peroxide cross‐linked UHMWPE blended with vitamin E

et al. 2016

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“…22 Although early results are promising, longer follow-up and large study cohorts will be required to determine if these will translate into improved clinical performance and durability of these implants. 60 …”

Section: Discussionmentioning

confidence: 99%

Tribology of total hip arthroplasty prostheses

Rieker

2016

EFORT Open Reviews

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Articulating components should minimise the generation of wear particles in order to optimize long-term survival of the prosthesis.A good understanding of tribological properties helps the orthopaedic surgeon to choose the most suitable bearing for each individual patient.Conventional and highly cross-linked polyethylene articulating either with metal or ceramic, ceramic-on-ceramic and metal-on-metal are the most commonly used bearing combinations.All combinations of bearing surface have their advantages and disadvantages. An appraisal of the individual patient’s objectives should be part of the assessment of the best bearing surface.Cite this article: Rieker CB. Tribology of total hip arthroplasty prostheses: what an orthopaedic surgeon should know. EFORT Open Rev 2016;1:52-57. DOI: 10.1302/2058-5241.1.000004.

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“…In addition to state-of the art technology incorporating antioxidants for long-term stability [44][45][46], a recent application of a surface treatment on the XLPE articulating surface has improved the wear resistance by covering its surface with a thin layer (100-200 nm) of chemically-bonded Poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC), which is formed by photo-induced graft polymerization; this material creates a super-lubricious layer that mimics articular cartilage [20]. A recent hip simulator study reported that MPC polymer grafted on the XLPE surface dramatically reduced the wear up to 70 million cycles [47].…”

Section: Introductionmentioning

confidence: 99%

Progress in Wear Resistant Materials for Total Hip Arthroplasty

et al. 2017

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Current trends in total hip arthroplasty (THA) are to develop novel artificial hip joints with high wear resistance and mechanical reliability with a potential to last for at least 25-30 years for both young and old active patients. Currently used artificial hip joints are mainly composed of femoral head of monolithic alumina or alumina-zirconia composites articulating against cross-linked polyethylene liner of acetabular cup or Co-Cr alloy in a self-mated configuration. However, the possibility of fracture of ceramics or its composites, PE wear debris-induced osteolysis, and hypersensitivity issue due to metal ion release cannot be eliminated. In some cases, thin ultra-hard diamond-based, TiN coatings on Ti-6A-4V or thin zirconia layer on the Zr-Nb alloy have been fabricated to develop high wear resistant bearing surfaces. However, these coatings showed poor adhesion in tribological testing. To provide high wear resistance and mechanical reliability to femoral head, a new kind of ceramic/metal artificial hip joint hybrid was recently proposed in which 10-15 µm thick dense layer of pure α-alumina was formed onto Ti-6Al-4V alloy by deposition of Al metal layer by cold spraying or cold metal transfer methods with 1-2 µm thick Al 3 Ti reaction layer formed at their interface to improve adhesion. An optimal micro-arc oxidation treatment transformed Al to dense α-alumina layer, which showed high Vickers hardness 1900 HV and good adhesion to the substrate. Further tribological and cytotoxicity analyses of these hybrids will determine their efficacy for potential use in THA.

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Three Year RSA Evaluation of Vitamin E Diffused Highly Cross-linked Polyethylene Liners and Cup Stability

Cited by 32 publications

References 15 publications

Peroxide cross‐linked UHMWPE blended with vitamin E

Peroxide cross‐linked UHMWPE blended with vitamin E

Tribology of total hip arthroplasty prostheses

Progress in Wear Resistant Materials for Total Hip Arthroplasty

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