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Highly Cross-Linked Polyethylenes

  • Robert M. StreicherEmail author
Chapter

Abstract

Osteolysis after total joint replacement using ultra-high molecular weight Polyethylene bearing components has been shown to be a major factor for the long-term failure of such components. Highly cross-linked polyethylene has already been introduced in the late 1970s and demonstrated to have superior wear resistance compared to non-irradiated and irradiation sterilized polyethylene used since 1962. In 1986 irradiation sterilization in inert gas was introduced and starting from 1998 modern highly cross-linked polyethylenes have been used as bearing surfaces for hip joint implants, followed by their usage for tibial inserts for total knee replacement. Despite a dramatic reduction in the wear rates and the positive clinical results with this second generation highly cross-linked polyethylenes, it was necessary to compromise between oxidation resistance and preservation of toughness, which has been addressed by various manufacturers in different ways. The newest third-generation of highly cross-linked polyethylene has been introduced in 2005/2007 and addresses the deficiencies of the previous generation by usage of enhanced technologies to minimize the compromise made with second-generation materials.

Keywords

Wear Rate Total Knee Replacement Total Joint Replacement Tibial Insert Irradiation Sterilization 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Barrack, R., Folgueras, A.: Pelvic lysis and polyethylene wear at 5–8 years in an uncemented total hip. Clin. Orthop. Relat. Res. 335, 211–217 (1997)PubMedGoogle Scholar
  2. 2.
    Bragdon, C.R., Greene, M.E., Rubash, H.R., Freiberg, A., Malchau, H.: Early RSA evaluation of wear of vitamin E stabilized highly cross-linked polyethylene and stability of a new acetabular component. Trans. 56th ORS: 2344 (2010)Google Scholar
  3. 3.
    Campbell, D.G., Field, J.R., Callary, S.A.: Second-generation highly cross-linked X3 polyethylene wear: a preliminary radiostereometric analysis study. Clin. Orthop. Relat. Res. 468(10), 2704–2709 (2010)PubMedCrossRefGoogle Scholar
  4. 4.
    D’Antonio, J.A., Capello, W.N., Bierbaum, B., Ramakrishnan, R.: Annealed highly crosslinked polyethylenes: clinical performance and second generation materials. Abstr. AAOS: 106 (2010)Google Scholar
  5. 5.
    Dumbleton, J.H., D’Antonio, J.A., Manley, M.A., et al.: The basis for a second-generation highly cross-linked UHMWPE. Clin. Orthop. Relat. Res. 453, 265–271 (2006)PubMedCrossRefGoogle Scholar
  6. 6.
    Edidin, A.A., Jewett, C.W., Kwarteng, K., et al.: Degradation of mechanical behavior in UHMWPE after natural and accelerated aging. Biomaterials 21, 1451–1460 (2000)PubMedCrossRefGoogle Scholar
  7. 7.
    Essner, A., Yau, S.-S., Schmidig, G., Wang, A., et al.: Reducing hip wear without compromising mechanical strength: a next generation cross-linked and annealed polyethylene. Trans. 5th combined ORS: 80 (2005)Google Scholar
  8. 8.
    Geerdink, C.H., Grimm, B., Vencken, W., et al.: Cross-linked compared with historical polyethylene in THA. Clin. Orthop. Relat. Res. 467(4), 979–984 (2009)PubMedCrossRefGoogle Scholar
  9. 9.
    Grobbelaar, C.J.: Longterm results with crosslinked PE. Abstr. 4th EFORT: 158 (1999)Google Scholar
  10. 10.
    Haider, H., Weisenburger, J.N., Kurtz, S., et al.: Highly crosslinked UHMWPE in TKA – does vitamin E-stabilized PE address our concerns? Trans. 55th ORS: 2328 (2009)Google Scholar
  11. 11.
    Harris, W.: Three revolutions in acetabular revision surgery. Abstr. 16th ISTA: 24–28 (2003)Google Scholar
  12. 12.
    Hermida, J.C., Fischler, A., Colwell, C.W., D’Lima, D.D.: The effect of oxidative aging on the wear performance of highly crosslinked polyethylene knee inserts under conditions of severe malalignment. J. Orthop. Res. 26(12), 1585–1590 (2008)PubMedCrossRefGoogle Scholar
  13. 13.
    Herrera, L., Lee, R., Longaray, J., et al.: Hip simulator evaluation of the effect of femoral head size on sequentially cross-linked acetabular liners. Wear 263, 1034–1037 (2007)CrossRefGoogle Scholar
  14. 14.
    Johanson, P.-E., Digas, G., Thanner, J., et al.: Clinical performance of highly cross-linked polyethylene with seven years follow-up. Trans. 56th ORS: 357 (2010)Google Scholar
  15. 15.
    Kelly, N.H., Rajadhyaksha, A.D., Wright, T.M., et al.: High stress conditions do not increase wear of thin highly crosslinked UHMWPE. Clin. Orthop. Relat. Res. 468, 418–423 (2009)CrossRefGoogle Scholar
  16. 16.
    King. R., Narayan, V.S., Ernsberger, C., Hanes, M.: Characterization of gamma-irradiated UHMWPE stabilized with a hindered-phenol antioxidant. Trans. 55th ORS: 19 (2009)Google Scholar
  17. 17.
    Leer, R., Zurbruegg, D., Delfosse, D.: Use of vitamin E to protect cross-linked UHMWPE from oxidation. Biomaterials 31, 3643–3648 (2010)CrossRefGoogle Scholar
  18. 18.
    Martell, J., Clohisy, J., White, R., et al.: Multi-center study of the mid-term follow-up results of highly cross-linked polyethylene THR components. Trans. 56th ORS: 359 (2010)Google Scholar
  19. 19.
    MacDonald, D., Sakona, A., Austin, M., Parvizi, J., Kurtz, S.M.: Comparison of first – and second-generation annealed polyethylenes for total hip arthroplasty. Trans. 56th ORS: 2351 (2010)Google Scholar
  20. 20.
    Oonishi, H.: Long term clinical results of THR. Clinical results of THR of an alumina head with a cross-linked UHMWPE cup. Orthop. Surg. Traumatol 38, 1255–1264 (1995)Google Scholar
  21. 21.
    Oral, E., Christensen, S.D., Mahlhi, A.S., Wannomae, K.K., Muratoglu, O.K.: Wear resistance and mechanical properties of highly cross-linked UHMWPE doped with vitamin E. J. Arthroplasty 21(4), 580–521 (2006)PubMedCrossRefGoogle Scholar
  22. 22.
    Oral, E., Wannomae, K.K., Rowell, S.L., Muratoglu, O.K.: Diffusion of vitamin E in UHMWPE. Biomaterials 28, 5225–5237 (2007)PubMedCrossRefGoogle Scholar
  23. 23.
    Roehrl, S.M., Li, M.G., Nilsson, K.G., Nivbrant, B.: Very low wear of non-remelted highly cross-linked polyethylene cups: An RSA study lasting up to 6 years. Acta Orthop. 78(6), 739–745 (2007)CrossRefGoogle Scholar
  24. 24.
    Rowell, S.L., Duffy, G., Wannomae, K.K., et al.: Failure of a Marathon™ UHMWPE acetabular liner: a case study. Trans. 53rd ORS: 1646 (2007)Google Scholar
  25. 25.
    Rowell, S.L., Yabannavar, P., Muratoglu, O.K.: Oxidative stability of simulator-tested acetabular liners after 7-years shelf aging in air. Trans. 56thORS: 358 (2010)Google Scholar
  26. 26.
    Schmalzried, T.P., Szuszczewicz, E.S., Northfield, M.R., et al.: Quantitative Assessment of Walking Activity after Total Hip or Knee Replacement. J. Bone Joint Surg. 80A, 54–59 (1998)Google Scholar
  27. 27.
    Shih, C.-H., Lee, P.-C., et al.: Measurement of polyethylene wear in cementless total hip arthroplasty. J. Bone Joint Surg. 79-B, 361–365 (1997)CrossRefGoogle Scholar
  28. 28.
    Streicher, R.M.: Investigation on sterilization and modification of high molecular weight polethylenes by ionizing irradiation. Beta Gamma 89(1), 34–43 (1989)Google Scholar
  29. 29.
    Streicher, R.M.: UHMWPE as the substance for articulating components of joint prostheses. Biomed. Tech. 38(12), 303–313 (1993)CrossRefGoogle Scholar
  30. 30.
    Streicher, R.M., Wang, A.: Mechanical and tribological properties of cross-linked UHMWPE. Riv. patologia ’apparato locomotore Vol II(1, 2), 39–46 (2003)Google Scholar
  31. 31.
    Taylor, S., Serekian, P., Bruchalski, P., Manley, M.T.: The performance of irradiation-crosslinked UHMWPE cups under abrasive conditions throughout hip simulation testing. Trans. 45thORS: 252 (1999)Google Scholar
  32. 32.
    Wang, A., Manley, M.T., Serekian, P.: Wear and structural fatigue simulation of crosslinked ultra-high molecular weight polyethylene for hip and knee bearing applications. ASTM STP 1445, 151–168 (2003)Google Scholar
  33. 33.
    Willie, B.M., Bloebaum, R.D., Ashrafi, S., et al.: Oxidative degradation in highly cross-linked and conventional polyethylene after 2 years of real time shelf aging. Biomaterials 27, 2275–2284 (2006)PubMedCrossRefGoogle Scholar
  34. 34.
    Wroblewski, B.M., Siney, P.D., Fleming, P.A.: Low-friction arthroplasty of the hip using alumina ceramic and cross-linked polyethylene. J. Bone Joint Surg. 81B(1), 54–55 (1990)Google Scholar
  35. 35.
    Yau, S.S., Wang, A., Lovell, T.: Evidence of compromised performance properties in vitamin E-doped irradiated UHMWPE. Abstr. 8th World Biomaterials Congress: 1691 (2008)Google Scholar
  36. 36.
    Yau, S.S., Le, K.-P., Wang, A.: Doping vitamin E by diffusion deteriorates properties of crosslinked UHMWPE: verified by experiments. Trans. 55th ORS: 458 (2009)Google Scholar
  37. 37.
    Yau, S.-S., Le, K.-P., Blitz, J.W., Dumbleton, J.H.: Real-time shelf aging of sequential crosslinked and annealed UHMWPE. Trans. 55th ORS: 450 (2009)Google Scholar

Copyright information

© Springer Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.RüschlikonSwitzerland

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