title: Does vitamin E-stabilized ultrahigh-molecular-weight polyethylene address concerns of cross-linked polyethylene in total knee arthroplasty?
abstract: Concerns about reduced strength, fatigue resistance, and oxidative stability of highly cross-linked and remelted ultrahigh-molecular-weight polyethylene (UHMWPE) have limited its clinical acceptance for total knee arthroplasty. We hypothesized that a highly cross-linked UHMWPE stabilized with vitamin E would have less oxidation and loss of mechanical properties. We compared the oxidation, in vitro strength, fatigue-crack propagation resistance, and wear of highly cross-linked UHMWPE doped with vitamin E to γ-inert-sterilized direct compression-molded UHMWPE (control). After accelerated aging, the control material showed elevated oxidation, loss of small-punch mechanical properties, and loss of fatigue-crack propagation resistance. In contrast, the vitamin E-stabilized material had minimal changes and exhibited 73% to 86% reduction in wear for both cruciate-retaining and posterior-stabilized total knee arthroplasty designs. Highly cross-linked vitamin E-stabilized UHMWPE performed well in vitro.
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Nebraska Medical, Center, Omaha, Nebraska 68198, USA.
authors.forename: Hani
authors.initials: H
authors.lastname: Haider
authors.forename: Joel N
authors.initials: JN
authors.lastname: Weisenburger
authors.forename: Steven M
authors.initials: SM
authors.lastname: Kurtz
authors.forename: Clare M
authors.initials: CM
authors.lastname: Rimnac
authors.forename: Jordan
authors.initials: J
authors.lastname: Freedman
authors.forename: David W
authors.initials: DW
authors.lastname: Schroeder
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Garvin
mesh_terms: D019645:Arthroplasty, Replacement, Knee; D007720:Knee Prosthesis; D008422:Materials Testing; D020959:Polyethylene; D011095:Polyethylenes; D011474:Prosthesis Design; D013997:Time Factors; D014810:Vitamin E
chemical_list: D011095:Polyethylenes; C111601:ultra-high molecular weight polyethylene; D014810:Vitamin E; D020959:Polyethylene