Impact of gamma sterilization on clinical performance of polyethylene in the knee

Damage and rapid wear of the ultrahigh-molecular-weight polyethylene bearings of knee components continue to be major sources of failure of knee prostheses. Despite considerable research into the roles of design, polyethylene thickness and quality, and component alignment, the source of the rapid wear failures has remained a mystery. This study documents elevated oxidation resulting from the use of gamma sterilization in air, the most common sterilization technique used by the orthopaedic implant industry. This oxidation reduces static strength and elongation properties and significantly decreases the resistance of polyethylene bearings to fatigue, a frequent source of early damage of many of these devices.