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Oxidative properties and surface damage mechanisms of remelted highly crosslinked polyethylenes in total knee
Daniel W MacDonald1, Genymphas Higgs, Javad Parvizi
1Implant Research Center, Drexel University, Philadelphia, PA 19104, USA.
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.
