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In vivo oxidation in retrieved highly crosslinked tibial inserts.

B H Currier1, D W Van Citters, J H Currier

  • 1Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire 03755, USA. barbara.h.currier@dartmouth.edu

Journal of Biomedical Materials Research. Part B, Applied Biomaterials
|September 22, 2012
PubMed
Summary
This summary is machine-generated.

Oxidation of highly crosslinked (HXL) ultra-high-molecular-weight polyethylene (UHMWPE) tibial inserts can occur in vivo, particularly in annealed implants, potentially impacting implant longevity and leading to fatigue damage.

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Area of Science:

  • Biomaterials Science
  • Orthopedic Surgery
  • Materials Engineering

Background:

  • Ultra-high-molecular-weight polyethylene (UHMWPE) is a common bearing material in total knee arthroplasty.
  • Highly crosslinked (HXL) UHMWPE offers improved wear resistance but its oxidation behavior requires further investigation.
  • Understanding oxidation is crucial for predicting the long-term performance of HXL UHMWPE tibial inserts.

Purpose of the Study:

  • To determine the in vivo or postexplant oxidation environment of retrieved HXL UHMWPE tibial inserts.
  • To assess the influence of fabrication variables (irradiation source, dose) and post-irradiation thermal processing (annealing, remelting) on oxidation resistance.
  • To test hypotheses regarding in vivo oxidation potential and differential oxidation rates between annealed and remelted HXL UHMWPE.

Main Methods:

  • Analysis of 87 retrieved HXL UHMWPE tibial inserts using Fourier transform infrared spectroscopy.
  • Quantification of oxidation and trans-vinylene index.
  • Correlation of oxidation measurements with in vivo time, fabrication variables, and thermal processing.

Main Results:

  • Subsurface oxidation was observed in 56% of retrieved HXL tibial inserts, correlating with in vivo time and thermal processing.
  • Annealed HXL UHMWPE exhibited significantly higher articular oxidation rates compared to remelted UHMWPE (p < 0.001).
  • Oxidation rates correlated positively with crosslinking irradiation dose and post-irradiation thermal processing.

Conclusions:

  • In vivo oxidation of HXL UHMWPE tibial inserts is a significant concern, particularly for annealed implants.
  • Fabrication and thermal processing methods critically influence UHMWPE oxidation resistance.
  • Oxidation-induced loss of toughness in UHMWPE may contribute to fatigue damage in retrieved tibial inserts, with potential clinical implications.