Wear Resistance and Mechanical Properties of Highly Cross-linked, Ultrahigh–Molecular Weight Polyethylene Doped With Vitamin E

Oral, Ebru; Christensen, Steven D.; Malhi, Arnaz S.; Wannomae, Keith K.; Muratoglu, Orhun K.

doi:10.1016/j.arth.2005.07.009

Cited by 279 publications

(222 citation statements)

References 37 publications

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“…gamma sterilization [55,62], the wear reduction in irradiated/vitamin E-diffused UHMWPE compared to conventional UHMWPE was comparable to that observed previously with irradiated and melted UHMWPE compared to conventional UHMWPE [50,52]. A study comparing the wear of vitamin E-blended (0.3 wt%), unirradiated UHMWPE versus conventional UHMWPE in a knee simulator showed lower wear volume and different debris for the former [75], suggesting vitamin E alone may improve the wear/delamination resistance [77].…”

Section: Effects Of Vitamin E On Microstructure Tribologic and Mechsupporting

confidence: 74%

“…Under accelerated aging at elevated temperatures and/or in the presence of pure oxygen, vitamin E-stabilized, irradiated UHMWPE was oxidatively more stable than gamma-sterilized or high-dose irradiated UHMWPE [11,55,60,62,84]. Thus, in vitro studies corroborated the hypothesis that vitamin E would increase the oxidative stability of irradiated UHMWPEs.…”

Section: The Rationale For Using the Antioxidant Vitamin Ementioning

confidence: 64%

“…The strength of vitamin E-stabilized UHMWPE remained unchanged when accelerated aged, while that of gammasterilized UHMWPE deteriorated considerably [55,59]. Vitamin E alone had no effect on the mechanical properties of UHMWPE [75].…”

Section: Effects Of Vitamin E On Microstructure Tribologic and Mechmentioning

confidence: 92%

“…The rationale for using vitamin E was twofold: improving oxidation resistance of irradiated UHMWPEs and improving the fatigue strength of irradiated UHMWPEs using an alternative to postirradiation melting [9,11,42,44,55,62,82].…”

Section: The Rationale For Using the Antioxidant Vitamin Ementioning

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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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: Effects Of Vitamin E On Microstructure Tribologic and Mechsupporting

confidence: 74%

Section: The Rationale For Using the Antioxidant Vitamin Ementioning

confidence: 64%

Section: Effects Of Vitamin E On Microstructure Tribologic and Mechmentioning

confidence: 92%

Section: The Rationale For Using the Antioxidant Vitamin Ementioning

confidence: 99%

See 2 more Smart Citations

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

Bracco

Oral

2011

Clinical Orthopaedics &Amp; Related Research

Self Cite

256

162

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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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Antioxidant Polymers for Tuning Biomaterial Biocompatibility: From Drug Delivery to Tissue Engineering

Cochran¹,

Dziubla²

2012

Antioxidant Polymers

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Wear Resistance and Mechanical Properties of Highly Cross-linked, Ultrahigh–Molecular Weight Polyethylene Doped With Vitamin E

Cited by 279 publications

References 37 publications

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

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

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

Antioxidant Polymers for Tuning Biomaterial Biocompatibility: From Drug Delivery to Tissue Engineering

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