Unified wear model for highly crosslinked ultra-high molecular weight polyethylenes (UHMWPE)

Muratoglu, Orhun K.; Bragdon, Charles R.; O’Connor, Daniel; Jasty, Murali; Harris, William H.; Gul, Rizwan M.; McGarry, Frederick J.

doi:10.1016/s0142-9612(99)00039-3

Cited by 423 publications

(315 citation statements)

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“…31,[34][35][36] It seems clear that the adhesive and abrasive wear of tibial inserts simulated in vitro decreased markedly with increased radiation-induced crosslinking, as is seen with THA acetabular cups. [9][10][11] In addition, we demonstrated that irradiation doses of more than 100 kGy provided little effectiveness in further reducing the wear rate of the crosslinked UHMWPE inserts, which is also similar to the results seen with crosslinked acetabular cups.…”

Section: Discussionsupporting

confidence: 70%

“…[1][2][3][4][5] In total hip arthroplasty (THA), crosslinking of UHMWPE was shown both clinically [6][7][8] and experimentally 5,[9][10][11] to be highly effective in reducing wear. Using a hip simulator, Wang et al 5 reported that the wear rate of UHMWPE acetabular cups was reduced exponentially as the radiation dose increased, with up to a 90% reduction with 50 kGy.…”

Section: Introductionmentioning

confidence: 99%

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Wear and toughness of crosslinked polyethylene for total knee replacements: A study using a simulator and small‐punch testing

Akagi

Asano

Clarke

et al. 2006

Journal Orthopaedic Research

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Severe loading and complex kinematics in total knee replacement make wear performance and toughness of the polyethylene in tibial inserts important. We investigated wear of crosslinked polyethylene using a knee simulator and measured toughness using small-punch testing. GUR1050 rods were gamma-irradiated in air at doses from 0 to 200 kGy, annealed in nitrogen, and machined into tibial inserts. The simulator was run to 4 million cycles, and wear rates determined from weight loss. Wear rate decreased by 54, 78, and 95% as radiation dose increased from 50 to 75 to 100 kGy, respectively. At every dose, toughness was significantly less after simulator testing, but the difference between control and wear-tested polyethylene, considered to be due to fatigue damage accumulation, was smallest at 50 kGy. The simulator-tested polyethylene that received 35 to 75 kGy had slightly higher toughness than equivalent material that received no irradiation. However, the toughness of simulator-tested polyethylene that received 150 and 200 kGy was lower than that of the simulator-tested polyethylene that received no irradiation. Our results suggest that an optimal irradiation dose may exist for crosslinked polyethylene for use in TKR and that the optimum dose would be less than the 100 kGy or more that are used in some current crosslinked polyethylene for hip replacement. ß

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Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Wear and toughness of crosslinked polyethylene for total knee replacements: A study using a simulator and small‐punch testing

Akagi

Asano

Clarke

et al. 2006

Journal Orthopaedic Research

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“…Oxidation and subsequent embrittlement of UHMWPE decrease the abrasive wear resistance and increase the wear debris associated with the polymer [9,27,28,49]. Radiation crosslinking of UHMWPE reduces wear in vitro [48,50,51,53] and in vivo [29,47] but also induces free radicals, which can cause oxidation. Postirradiation melting renders crosslinked UHMWPE oxidation-resistant by allowing these residual free radicals trapped in the crystalline regions [8,40] to recombine.…”

Section: Introductionmentioning

confidence: 99%

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

Bracco

Oral

2011

Clinical Orthopaedics &Amp; Related Research

256

162

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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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“…Radiation crosslinking and heat treatment of UHMWPE has proven to be an important advance for improved wear resistance (1)(2)(3)(4). Some of these improved UHMWPEs have been in clinical use since 1998 with early clinical studies showing markedly reduced wear rates with the highly crosslinked UHMWPEs in comparison with conventional UHMWPEs (5,6).…”

Section: Introductionmentioning

confidence: 99%

“…Typically, a post-irradiation treatment step follows the radiation cross-linking of UHMWPE used in total joint applications to decrease the concentration of the residual free radicals and to minimize or eliminate the adverse effects of residual free radicals on the properties of UHMWPE (1,2,4). The most effective method of stabilization is to melt the irradiated UHMWPE, which reduces the concentration of the residual free radicals to undetectable levels (3).…”

Section: Introductionmentioning

confidence: 99%

The effect of α-tocopherol on the oxidation and free radical decay in irradiated UHMWPE

2006

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We developed a radiation cross-linked UHMWPE stabilized with a-tocopherol (Vitamin E) as a bearing material in total joint replacements. The stabilizing effect of a-tocopherol on free radical reactions in UHMWPE is not well understood. We investigated the effect of a-tocopherol on the oxidation and transformation of residual free radicals during real-time aging of a-tocopherol-doped, irradiated UHMWPE (aTPE) and irradiated UHMWPE (control). Samples were aged at 22° C (room temperature) in air, at 40°C in air, and at 40°C in water for seven months. During the first month, aTPE showed some oxidation at the surface, which stayed constant thereafter. Control exhibited substantial oxidation in the subsurface region, which increased with time. The alkyl/allyl free radicals transformed to oxygen centered ones in both materials; this transformation occurred faster in a-TPE. In summary, the real-time oxidation behavior of a-TPE was consistent with that observed using accelerated aging methods. This new UHMWPE is oxidation resistant and is expected to maintain its properties in the long-term.

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Unified wear model for highly crosslinked ultra-high molecular weight polyethylenes (UHMWPE)

Cited by 423 publications

References 0 publications

Wear and toughness of crosslinked polyethylene for total knee replacements: A study using a simulator and small‐punch testing

Wear and toughness of crosslinked polyethylene for total knee replacements: A study using a simulator and small‐punch testing

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

The effect of α-tocopherol on the oxidation and free radical decay in irradiated UHMWPE

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