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Lubricant composition is known to affect in vitro (simulator) wear of polymeric acetabular components. Clinical acetabular components, fabricated from both ultrahigh molecular weight polyethylene (UHMWPE) and polytetrafluoroethylene (PTFE), were tested against cobalt-chromium 32-mm ball heads, with the use of various lubricants, with different compositions and concentrations of bovine and calf serum as well as hyaluronic acid, in tests which lasted one million cycles. The type of proteins and their relative concentration in the lubricant affected the wear rate of both UHMWPE and PTFE. Increasing protein concentration reduced the UHMWPE wear rate but increased the PTFE wear rate. For a given total protein concentration, increasing the albumin/globulin (A/G) ratio led to a significant reduction in the wear rate for PTFE. A similar but smaller effect was found for UHMWPE. The relative wear-rate ratio between PTFE and UHMWPE depends on both the total protein concentration and the specific protein concentration (albumin/globulin ratio). The average clinical wear rates for both PTFE and UHMWPE and the average wear-rate ratios between them were reproduced when the serum lubricant contained total protein concentration and A/G ratio within normally observed physiological ranges. It is recommended that lubricants for simulator testing be standardized to control total protein content as well as albumin/ globulin ratio.

The effect of very low concentrations of Vitamin E on the stability and mechanical behavior of UHMWPE remains unknown. We tested the hypothesis that the oxidation resistance of Vitamin E-blended UHMWPE would be influenced by trace doses of antioxidant, resin, and radiation treatment. Trace concentrations (< or =500 ppm w/w%) of alpha-tocopherol (Vitamin E) were blended separately with GUR 1020 and 1050 resins and molded into disks. From each disk, three groups of 10 mm thick blocks were machined: (1) no irradiation (control); (2) 30 kGy of gamma irradiation in nitrogen; and (3) 75 kGy of gamma irradiation in air. Specimens were subjected to three aging protocols: (a) no aging (control); (b) two weeks and (c) four weeks of accelerated aging in accordance with ASTM F 2003 (i.e., 70 degrees C and 5 atm oxygen). The minimum concentration of Vitamin E needed to stabilize UHMWPE during our accelerated tests depended upon the method of radiation processing. For the 30 and 75 kGy irradiated materials, the addition of 125 ppm or more Vitamin E was sufficient to maintain baseline mechanical and chemical properties through two weeks of accelerated aging. For these groups, the addition of 375 ppm or 500 ppm, respectively, was necessary to maintain baseline mechanical and chemical properties throughout the four-week accelerated aging period. UHMWPE resin molecular weight did not have an effect on oxidation behavior. The results of this experiment therefore supported our hypotheses that trace concentrations of Vitamin E, coupled with radiation treatment-but not resin grade-influence the mechanical and oxidative degradation behavior of UHMWPE.

No abstract

Ultra high molecular weight polyethylene (UHMWPE) has been used as a bearing surface in joint replacement prostheses for over 40 years. Recently, highly crosslinked UHMWPE (HXPE) materials were introduced based on the finding that crosslinking reduces wear. These first generation HXPE materials were produced by irradiation followed by heating below the melting temperature (annealing) or above the melting temperature (remelting). Both classes of HXPE material have demonstrated greatly reduced wear. However, remelted HXPE materials have reduced fatigue strength while annealed HXPE materials may oxidize when exposed to oxygen. A second generation HXPE material was produced using a sequential irradiation and annealing process (SXL). SXL materials have crosslinking levels equivalent to those of first generation HXPE materials, have fatigue and mechanical strength characteristics of first generation annealed HXPE material and have an oxidation resistance equivalent to that of virgin (unprocessed) UHMWPE. This combination of properties makes SXL HXPE a preferred material for bearing surfaces of joint prostheses.