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Oxidative properties and surface damage mechanisms of remelted highly crosslinked polyethylenes in total knee arthroplasty

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Abstract

Purpose

Remelted highly crosslinked polyethylenes (HXLPEs) were introduced in total knee replacement (TKR) starting in 2001 to reduce wear and particle-induced lysis. The purpose of this study was to investigate the damage mechanisms and oxidative stability of remelted HXLPEs used in TKR.

Methods

A total of 186 posteriorly stabilised tibial components were retrieved at consecutive revision operations. Sixty nine components were identified as remelted HXLPE. The conventional inserts were implanted for 3.4 ± 2.7 years, while the remelted components were implanted 1.4 ± 1.2 years. Oxidation was assessed using Fourier transform infrared spectroscopy.

Results

Remelted HXLPE inserts exhibited lower oxidation indices compared to conventional inserts. We were able to detect slight regional differences within the HXLPE cohort, specifically at the bearing surface.

Conclusion

Remelted HXLPE was effective at reducing oxidation in comparison to gamma inert sterilised controls. Additional long-term HXLPE retrievals are necessary to ascertain the long term in vivo stability of these materials in TKR.

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Acknowledgments

This study was supported by the National Institutes of Health (NIAMS) R01 AR47904. Institutional support has been received from Zimmer, Stryker, Stelkast, Sulzer, and the Wilbert J. Austin Professor of Engineering Chair (CMR).

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Authors and Affiliations

  1. Implant Research Center, Drexel University, 3401 Market St., Suite 345, Philadelphia, PA, 19104, USA

    Daniel W. MacDonald, Genymphas Higgs & Steven M. Kurtz

  2. Rothman Institute, Philadelphia, PA, 19104, USA

    Javad Parvizi

  3. Hartzband Center for Hip & Knee Replacement, Paramus, NJ, USA

    Gregg Klein, Mark Hartzband & Harlan Levine

  4. Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, OH, USA

    Matthew Kraay & Clare M. Rimnac

  5. Implant Research Center, Drexel University, 3401 Market St. Suite 345, Philadelphia, PA, 19104, USA

    Steven M. Kurtz

Authors
  1. Daniel W. MacDonald
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  2. Genymphas Higgs
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  3. Javad Parvizi
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  4. Gregg Klein
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  5. Mark Hartzband
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  6. Harlan Levine
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  7. Matthew Kraay
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  8. Clare M. Rimnac
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  9. Steven M. Kurtz
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Corresponding author

Correspondence to Steven M. Kurtz.

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MacDonald, D.W., Higgs, G., Parvizi, J. et al. Oxidative properties and surface damage mechanisms of remelted highly crosslinked polyethylenes in total knee arthroplasty. International Orthopaedics (SICOT) 37, 611–615 (2013). https://doi.org/10.1007/s00264-013-1796-6

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  • DOI: https://doi.org/10.1007/s00264-013-1796-6

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