In Vivo Oxidation and Surface Damage in Retrieved Ethylene Oxide-sterilized Total Knee Arthroplasties

MacDonald, Daniel W.; Hanzlik, J; Sharkey, Peter F.; Parvızı, Javad; Kurtz, Steven M.

doi:10.1007/s11999-011-2184-4

Cited by 22 publications

(12 citation statements)

References 28 publications

(42 reference statements)

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“…These results were consistent with previous retrieval studies of knee prostheses . On the other hand, delamination was not observed for ethylene oxide gas sterilized UHMWPE . Therefore, it was considered that materials with a delamination resistance score similar to or better than virgin UHMWPE, such as G100‐R2, VEPE, and VE‐E300, have little risk of delamination.…”

Section: Discussionsupporting

confidence: 90%

Evaluating the durability of UHMWPE biomaterials used for articulating surfaces of joint arthroplasty using delamination tests

et al. 2018

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Ultra-high molecular weight polyethylene (UHMWPE) is the most popular material used for the articulating surface of joint replacements. Delamination is a common fatigue-related failure mode in UHMWPE components; however, the relationship between delamination resistance and fatigue crack growth has not been reported. Here, the delamination resistance of contemporary UHMWPE materials, including highly cross-linked UHMWPE (HXLPE), vitamin E blended UHMWPE (VEPE), and vitamin E blended HXLPE (VEXLPE), was measured to verify a previously proposed accelerated test method using a U-shaped sliding motion; the results were compared with those of fatigue crack growth tests. The oxidative stability of each material was estimated using Fourier transform infrared analysis. UHMWPE sterilized by gamma irradiation in an inert atmosphere and annealed HXLPE had lower delamination resistance than virgin UHMWPE after artificial aging. This was consistent with previous findings from retrieval studies, and in vitro knee simulator and ball-on-flat unidirectional reciprocation wear studies. In contrast, remelted HXLPE, VEPE, and VEXLPE showed excellent delamination resistance after artificial aging. The results of the delamination tests were not consistent with those of fatigue crack growth tests, indicating the complex delamination mechanism and importance of evaluating these factors separately. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2018.

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Section: Discussionsupporting

confidence: 90%

Evaluating the durability of UHMWPE biomaterials used for articulating surfaces of joint arthroplasty using delamination tests

et al. 2018

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“…Therefore, in this study, delamination tests—which have been reported to be consistent with in vivo behavior—were also conducted (Sakoda et al, 2019). Virgin used in this study was equivalent to ethylene gas‐sterilized UHMWPE, which has been reported to experience no delamination in vivo (Greulich, Roy, & Whiteside, 2012; MacDonald, Hanzlik, Sharkey, Parvizi, & Kurtz, 2012). Therefore, a material having better delamination resistance than virgin is not at risk of clinical delamination (Sakoda et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

In vitro estimation of reduction in strength and wear resistance of UHMWPE for joint prostheses due to lipid‐induced degradation

2020

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Ultra-high molecular weight polyethylene (UHMWPE) is used as a bearing surface of joint prostheses and has been reported to absorb lipids such as squalene (SQ) and cholesterol esters in vivo. These lipids have been suggested by in vitro studies using SQ as a model lipid to have the potential to induce polymer degradation. However, the impact of lipid-induced degradation on the strength and wear resistance of UHMWPE is unknown. In this study, lipid-induced degradation was simulated by SQ absorption and subsequent accelerated aging, and its influence on the strength and wear resistance of UHMWPE was investigated using wear, fatigue crack growth, and delamination testing. Lipid-induced degradation was found to have little impact on fatigue crack growth rates and delamination resistance. These results were consistent with previous reports that lipid-induced degradation is localized near the surface. However, we also found that lipid-induced degradation increased the wear rate of both non-crosslinked and crosslinked UHMWPE by a factor of 2.5 and 14, respectively. These results indicate that lipid-induced degradation may affect the durability and long-term clinical outcome of joint replacements due to increased wear of UHMWPE.

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“…The specimens were tested according to ASTM F2183 using a small punch test rig and an Instron 5566 (Instron, Massachusetts, USA) materials testing machine at a displacement rate of 0.5 mm/min. Of the properties measured according to the standard, work to failure is considered a good metric when assessing oxidative degradation as it is a measure of the inherent toughness of the polymer [20]. Oxidative degradation may be apparent when the work to failure decreases as a function of time in situ.…”

Section: Methodsmentioning

confidence: 99%

Oxidation of Second Generation Sequentially Irradiated and Annealed Highly Cross-Linked X3™ Polyethylene Tibial Bearings

Kop

Pabbruwe

Keogh

et al. 2015

The Journal of Arthroplasty

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In Vivo Oxidation and Surface Damage in Retrieved Ethylene Oxide-sterilized Total Knee Arthroplasties

Abstract: Due to the stable oxidative and mechanical properties, EtO-sterilized tibial components appear to be an effective alternative to gamma-sterilized inserts, at least in short-term implantations.

Cited by 22 publications

References 28 publications

Evaluating the durability of UHMWPE biomaterials used for articulating surfaces of joint arthroplasty using delamination tests

Evaluating the durability of UHMWPE biomaterials used for articulating surfaces of joint arthroplasty using delamination tests

In vitro estimation of reduction in strength and wear resistance of UHMWPE for joint prostheses due to lipid‐induced degradation

Oxidation of Second Generation Sequentially Irradiated and Annealed Highly Cross-Linked X3™ Polyethylene Tibial Bearings

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