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

Bracco, Pierangiola; Oral, Ebru

doi:10.1007/s11999-010-1717-6

Cited by 256 publications

(169 citation statements)

References 59 publications

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“…These residual free radicals can migrate to the crystalline/amorphous interface and cause oxidation and reduction of UHMWPE elongation at break, tensile strength, fracture toughness and fatigue crack propagation resistance [33][34][35][36][37][38]. Therefore, to improve the oxidation resistance and the mechanical and fatigue strengths of cross-linked UHMWPE, antioxidant vitamin E is used to stabilise the radiation-induced free radicals [39][40][41][42]. The main role of vitamin E is to react with free radicals and protect the UHMWPE [39,43].…”

Section: Vitamin-e-stabilised Uhmwpementioning

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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Section: Vitamin-e-stabilised Uhmwpementioning

confidence: 99%

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

2015

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“…Therefore, further improvements in polyethylene durability are still needed to eliminate the clinical problems resulting from polyethylene wear. Current developments, like the stabilization of highly crosslinked polyethylene with vitamin E, could possibly provide the solution for polyethylene wear in the future [5,26,37].…”

Section: Discussionmentioning

confidence: 99%

Do Monoblock Cups Improve Survivorship, Decrease Wear, or Reduce Osteolysis in Uncemented Total Hip Arthroplasty?

Halma

Charles

Dhert

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Monoblock acetabular components used in uncemented total hip arthroplasty (THA) have certain mechanical characteristics that potentially reduce acetabular osteolysis and polyethylene wear. However, the degree to which they achieve this goal is not well documented. Questions/purposes The purpose of this study was to use a systematic review of controlled trials to test the hypothesis that monoblock cups have superior (1) polyethylene wear rate; (2) frequency of cup migration; (3) frequency of acetabular osteolysis; and (4) frequency of aseptic loosening compared with modular components used in uncemented THA.Methods A systematic search was conducted in the Medline, Embase, and Cochrane electronic databases to assemble all controlled trials comparing monoblock with modular uncemented acetabular components in primary THA. Included studies were considered ''best evidence'' if the quality score was either C 50% on the Cochrane Back Review Group checklist or C 75% the Newcastle-Ottawa quality assessment scale. A total of seven publications met our inclusion criteria. Results Best evidence analysis showed no difference in polyethylene wear rate, the frequency of cup migration, and aseptic loosening between monoblock and modular acetabular components. No convincing evidence was found for the claim that lower frequencies of acetabular osteolysis are observed with the use of monoblock cups compared with modular uncemented cups. Conclusions The purported benefits of monoblock cups were not substantiated by this systematic review of controlled studies in that polyethylene wear rates and frequencies of cup failure and acetabular osteolysis were similar to those observed with modular implants. Other factors should therefore drive implant selection in cementless THA. Level of Evidence Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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“…PE wear particles from the acetabular liner are responsible for osteolysis, which may lead to aseptic loosening [10]. Many different strategies or techniques have been introduced to reduce the number of PE wear particles and extend the longevity of THA [5,16,25,26,29,34].…”

Section: Introductionmentioning

confidence: 99%

“…During gamma irradiation (for crosslinking or for sterilization), free radicals formed in the PE molecular structure cause embrittlement through a cascading oxidation reaction [7]. Hence, the incorporation of the antioxidant vitamin E (a-tocopherol) has been proposed to prevent oxidation and has been introduced into clinical use [5,15,34]. Vitamin E is a free radical scavenger and is well established as a biological antioxidant.…”

Section: Introductionmentioning

confidence: 99%

Multidirectional Wear and Impact-to-wear Tests of Phospholipid-polymer-grafted and Vitamin E-blended Crosslinked Polyethylene: A Pilot Study

Kyomoto

Moro

Takatori

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Modifying the surface and substrate of a crosslinked polyethylene (CLPE) liner may be beneficial for high wear resistance as well as high oxidative stability and excellent mechanical properties, which would be useful in contributing to the long-term performance of orthopaedic bearings. A grafted poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) layer on a vitamin E-blended crosslinked PE (HD-CLPE[VE]) surface may provide hydrophilicity and lubricity without compromising the oxidative stability or mechanical properties. Questions/purposes (1) Will the modifications (PMPC grafting and vitamin E blending) affect the lubrication characteristics of the CLPE surface? (2) Will the modifications affect wear resistance? (3) Will the modifications affect fatigue resistance? Methods We investigated the effects of surface and substrate modifications (PMPC grafting and vitamin E blending) on the wear and fatigue fracture of thin CLPE samples. For each of the untreated and PMPC-grafted CLPE surfaces with and without vitamin E blended (four groups), wettability and lubricity surface analyses were conducted as well as multidirectional wear and impact-towear tests using a pin-on-disk testing machine. Results The water wettability and lubricity (CLPE [mean ± 95% confidence interval]: 23.2°± 1.8°, 0.005 ± 0.001; HD-CLPE[VE]: 26.0°± 2.3°, 0.009 ± 0.003) of the PMPCgrafted surfaces were greater (p \ 0.001) than that (CLPE: 90.3°± 1.2°, 0.067 ± 0.015; HD-CLPE[VE]: 90.8°± 2.0°, 0.063 ± 0.008) of the untreated surface regardless of vitamin E additives. It was observed that the PMPC grafting (CLPE: 0.23 ± 0.06 mg; HD-CLPE[VE]: 0.05 ± 0.10 mg) was associated with reduced gravimetric wear (CLPE: 0.53 ± 0.08 mg, p = 0.004 HD-CLPE[VE]: 0.23 ± 0.07 mg, p = 0.038) in the multidirectional wear test. The PMPC-grafted surface characteristics did not appear to affect the impact fatigue resistance regardless of vitamin E blending. Conclusions PMPC grafting improved the surface hydrophilicity and lubricity, and it reduced the gravimetric wear in terms of multidirectional sliding. It did not result in differences in terms of the impact-to-unidirectional sliding regardless of vitamin E blending. Further research is needed to evaluate the wear resistance of PMPC-grafted HD-CLPE(VE) in long-term hip simulator tests under normal

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

Cited by 256 publications

References 59 publications

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

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

Do Monoblock Cups Improve Survivorship, Decrease Wear, or Reduce Osteolysis in Uncemented Total Hip Arthroplasty?

Multidirectional Wear and Impact-to-wear Tests of Phospholipid-polymer-grafted and Vitamin E-blended Crosslinked Polyethylene: A Pilot Study

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