title: A surface crosslinked UHMWPE stabilized by vitamin E with low wear and high fatigue strength.
abstract: Wear particle-induced periprosthetic osteolysis has been a clinical problem driving the development of wear resistant ultrahigh molecular weight polyethylene (UHMWPE) for total joint replacement. Radiation crosslinking has been used to decrease wear through decreased plastic deformation; but crosslinking also reduces mechanical properties including fatigue resistance, a major factor limiting the longevity of joint implants. Reducing UHMWPE wear with minimal detriment to mechanical properties is an unaddressed need for articular bearing surface development. Here we report a novel approach to achieve this by limiting crosslinking to the articular surface. The antioxidant vitamin E reduces crosslinking efficiency in UHMWPE during irradiation with increasing concentration, thus we propose to spatially control the crosslink density distribution by controlling the vitamin E concentration profile. Surface crosslinking UHMWPE prepared using this approach had high wear resistance and decreased crosslinking in the bulk resulting in high fatigue crack propagation resistance. The interface region did not represent a weakness in the material due to the gradual change in the crosslink density. Such an implant has the potential of decreasing risk of fatigue fracture of total joint implants as well as expanding the use of UHMWPE to younger and more active patients.
authors.affiliation: Massachusetts General Hospital, Department of Orthopaedic Surgery, Harris Orthopaedic Biomechanics and Biomaterials Laboratory, 55 Fruit Street, Boston, MA 02114, USA. eoral@partners.org
authors.forename: Ebru
authors.initials: E
authors.lastname: Oral
authors.forename: Bassem W
authors.initials: BW
authors.lastname: Ghali
authors.forename: Shannon L
authors.initials: SL
authors.lastname: Rowell
authors.forename: Brad R
authors.initials: BR
authors.lastname: Micheli
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Lozynsky
authors.forename: Orhun K
authors.initials: OK
authors.lastname: Muratoglu
mesh_terms: D019643:Arthroplasty, Replacement / Q000379:methods; D007595:Joint Prosthesis; D008422:Materials Testing; D008970:Molecular Weight; D011095:Polyethylenes / Q000737:chemistry*; D014810:Vitamin E / Q000737:chemistry*
chemical_list: D011095:Polyethylenes; D014810:Vitamin E