Ultra High Molecular-Weight Polyethylene (Uhmwpe) in Total Knee Replacement: Fabrication, Sterilisation and Wear

Blunn, G.; Preva, E. M. Brach del; Costa, Luigi; Fisher, J.; Freeman, M. A. R.

doi:10.1302/0301-620x.84b7.0840946

Cited by 23 publications

(15 citation statements)

References 26 publications

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“…Effects of g-irradiation on D In Figure 5 we showed D for UHMWPE subjected to girradiation which abstracts hydrogen and slightly lowers material density. 43 The resultant material has a lower overall crystallinity and an increased concentration of transvinylene bonds. 14,44 This process can be anticipated to leave behind H-sized free-volume holes in the material that can enhance diffusion of gaseous species commensurate in size.…”

Section: Discussionmentioning

confidence: 99%

Characterizing the free volume of ultrahigh molecular weight polyethylene to predict diffusion coefficients in orthopedic liners

et al. 2017

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Liners used in orthopedic devices are often made from ultrahigh molecular weight polyethylene (UHMWPE). A general predictive capability for transport coefficients of small molecules in UHMWPE does not exist, making it difficult to assess properties associated with leaching or uptake of small molecules. To address this gap, we describe here how a form of the Vrentas-Duda free volume model can be used to predict upper-bound diffusion coefficients (D) of arbitrary molecules within UHMWPE on the basis of their size and shape. Within this framework, the free-volume microstructure of UHMWPE is defined by analysis of a curated set of model diffusants. We determined an upper limit on D for vitamin E, a common antioxidant added to UHMWPE, to be 7.1 × 10 cm s . This means that a liner that contains 0.1 wt % or less Vitamin E and has <120 cm patient contacting surface area would elute <100 µg/day of vitamin E. Additionally, the model predicts that squalene and cholesterol-two pro-oxidizing biological compounds-do not penetrate over 820 µm into UHMWPE liners over the course of 5 years because their D is ≤7.1 × 10 cm s . © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2393-2402, 2018.

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Section: Discussionmentioning

confidence: 99%

Characterizing the free volume of ultrahigh molecular weight polyethylene to predict diffusion coefficients in orthopedic liners

et al. 2017

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“…UHMWPE oxidation, induced by high energy radiation sterilization, is the main cause of wear‐related implant failures 13–15, 21–23. Efforts have been made to improve the performance of UHMWPE, for example, through crosslinking and through reduction or elimination of oxidation by means of adequate sterilization methods, including addition of antioxidants, such as the alpha‐tocopherol (vitamin E) 24–28.…”

Section: Discussionmentioning

confidence: 99%

“…Ultra high molecular weight polyethylene (UHMWPE) is an important component of TJR. To improve its bearing properties and eliminate failure due to oxidation,13–15 new vitamin E‐containing UHMWPE was developed 16, 17. We hypothesized that the adhesion of two ATCC S. epidermidis , one biofilm producing and one non‐producing strain, and one clinical biofilm producing strain, could be different on polyethylenes (PEs) characterized by different chemical surface features.…”

mentioning

confidence: 99%

Vitamin E blended Uhmwpe may have the potential to reduce bacterial adhesive ability

Banche

Bracco

Bistolfi

et al. 2011

Journal Orthopaedic Research

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Biomaterial-associated infection (BAI), a clinical problem resulting in septic failure of joint replacement implants, is initiated by bacterial adhesion, often by Staphylococcus epidermidis. Ultra high molecular weight polyethylene (UHMWPE) is a material of choice for joint replacement; reducing the adhesion of S. epidermidis to the polymer could be a means to decrease infection. We examined the adhesion of two ATCC and one clinical strain of S. epidermidis to standard polyethylene (PE), vitamin E blended UHMWPE (VE-PE), and oxidized UHMWPE (OX-PE) after different incubation times: a significant (p < 0.01) decrease in the adhered staphylococci on VE-PE and a significantly higher incidence of the dislodged biofilm bacteria on OX-PE was observed compared with that registered on PE. With attenuated total reflectance (ATR)-FTIR spectroscopy before and after suspension in bacterial medium for 48 h, new absorptions were observed mainly in OX-PE, indicating adsorption of protein-like substances on the polymer surface. We hypothesized that the different hydrophilicity of the surfaces with different chemical characteristics influenced protein adsorption and bacterial adhesion. These results may have clinical implications concerning the prevention of septic loosening: the VE-PE could have the potential to reduce S. epidermidis adhesive ability if the preliminary data observed in these selected strains is further confirmed, as diversity among clinical strains is well known. ß

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“…The inserts used in these patients were irradiated in air rather than a vacuum, which may have predisposed them to delamination by oxidative chain scission. 13 In our study, only a few femoral components were cemented at the primary procedure. However, they were designed to enable removal, via the intercondylar space, of any cement spill from the posterior condyles of the knee.…”

Section: Discussionmentioning

confidence: 97%

The significance of surface changes on retrieved femoral components after total knee replacement

Lakdawala

Todo

Scott

2005

The Journal of Bone and Joint Surgery. British volume

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We investigated the changes in surface roughness of retrieved femoral components in 18 men and four women at revision knee surgery. The mean age at revision was 68.4 years and the mean period of implantation was for 55.6 months. Eighteen implants were retrieved for aseptic loosening and four for infection. The surface changes in the articulating areas were inspected visually and the roughness (Ra) analysed with a profilometer. Parallel scratching and burnishing were the two main forms of damage. The mean Ra measurements in the articulating areas showed no statistically significant difference when compared with those in a control area on either side of the patellar groove at the apex of the femoral flange. This suggests that it is not essential to revise a well-fixed and correctly aligned femoral component where the polished surface has become burnished or bears fine parallel scratches, if the revision is conducted solely for failure of the tibial component.

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Ultra High Molecular-Weight Polyethylene (Uhmwpe) in Total Knee Replacement: Fabrication, Sterilisation and Wear

Cited by 23 publications

References 26 publications

Characterizing the free volume of ultrahigh molecular weight polyethylene to predict diffusion coefficients in orthopedic liners

Characterizing the free volume of ultrahigh molecular weight polyethylene to predict diffusion coefficients in orthopedic liners

Vitamin E blended Uhmwpe may have the potential to reduce bacterial adhesive ability

The significance of surface changes on retrieved femoral components after total knee replacement

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