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Vitamin E diffused, highly crosslinked UHMWPE: a review.

Ebru Oral1, Orhun K Muratoglu

  • 1Harris Orthopaedic Laboratory, Massachusetts General Hospital, 55 Fruit St. GRJ 1206, Boston, MA 02114, USA. eoral@partners.org

International Orthopaedics
|December 2, 2010
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Summary
This summary is machine-generated.

Highly crosslinked UHMWPE with vitamin E offers improved oxidation resistance and fatigue strength for hip and knee replacements. This advanced material demonstrates no adverse biological effects, enhancing its suitability for orthopedic implants.

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Area of Science:

  • Biomaterials Science
  • Orthopedic Engineering
  • Polymer Science

Background:

  • Highly crosslinked ultra-high molecular weight polyethylene (UHMWPE) is a preferred bearing material for total hip arthroplasty.
  • Early crosslinked UHMWPEs improved wear and osteolysis but required thermal treatment, impacting fatigue strength or oxidation resistance.
  • Vitamin E diffusion offers a method to stabilize crosslinked UHMWPE against oxidation while preserving fatigue strength.

Purpose of the Study:

  • To evaluate the efficacy of vitamin E diffusion in stabilizing radiation crosslinked UHMWPE.
  • To assess the oxidation resistance, fatigue strength, and biological compatibility of vitamin E-stabilized UHMWPE.
  • To compare the performance of vitamin E-stabilized UHMWPE with conventional and other crosslinked UHMWPEs.

Main Methods:

  • A two-step diffusion process was used to incorporate vitamin E into irradiated UHMWPE.
  • In vitro accelerated and real-time aging studies were conducted to evaluate oxidation resistance.
  • Fatigue strength testing was performed, and impingement simulations were utilized.
  • In vivo studies in rabbits and canines assessed tissue reaction and device fixation.

Main Results:

  • Vitamin E-diffused UHMWPE exhibited superior oxidation resistance compared to UHMWPE with residual free radicals.
  • Fatigue strength was improved in vitamin E-stabilized UHMWPE versus melted crosslinked UHMWPE.
  • Adverse impingement testing simulations showed satisfactory material behavior.
  • In vivo studies revealed no detrimental effects of vitamin E on tissue reaction or device fixation.

Conclusions:

  • Vitamin E diffusion is an effective method for stabilizing radiation crosslinked UHMWPE, enhancing oxidation resistance and fatigue strength.
  • This material demonstrates favorable biological compatibility and mechanical performance for orthopedic applications.
  • Clinical use since 2007 (hips) and 2008 (knees) warrants continued monitoring of long-term outcomes.